title: Risk of Nongenitourinary Cancers in Patients With Spinal Cord Injury: A Population-based Cohort Study.
abstract: Little information is available regarding the risk of nongenitourinary (GU) cancers in patients with spinal cord injury (SCI). The authors conducted a nationwide population-based study to investigate whether a higher risk of non-GU cancer is seen among patients with SCI.Data retrieved from the National Health Insurance Research Database of Taiwan were used in this study. A total of 41,900 patients diagnosed with SCI between 2000 and 2011 were identified from the National Health Insurance Research Database and comprised the SCI cohort. Each of these patients was randomly frequency matched with 4 people from the general population (without SCI) according to age, sex, comorbidities, and index year. Cox proportional hazards regression analysis was used to calculate adjusted hazard ratios and 95% confidence intervals and determine how SCI affected non-GU cancer risk.No significant difference in overall non-GU cancer risk was observed between the SCI and control groups. The patients with SCI exhibited a significantly higher risk of developing esophageal, liver, and hematologic malignancies compared with those without SCI. By contrast, the SCI cohort had a significantly lower risk of colorectal cancer compared with the non-SCI cohort (adjusted hazard ratio = 0.80, 95% confidence interval = 0.69-0.93). Additional stratified analyses by sex, age, and follow-up duration revealed various correlations between SCI and non-GU cancer risk.The patients with SCI exhibited higher risk of esophageal, liver, and hematologic malignancies but a lower risk of colorectal cancer compared with those without SCI. The diverse patterns of cancer risk among the patients with SCI may be related to the complications of chronic SCI.
authors.affiliation: From the Lab of Biomaterials, School of Chinese Medicine, China Medical University, Taichung (C-HK, Y-SC), Department of Chinese Medicine, Taipei Medical University Hospital, Taipei (C-HK), Department of Radiation Oncology, Zuoying Branch of Kaohsiung Armed Forces General Hospital, Kaohsiung (L-MS), Department of Bioinformatics and Medical Engineering, Asia University, Wufeng District, Taichung, Taiwan (Y-SC), Management Office for Health Data, China Medical University Hospital (C-LL), College of Medicine, China Medical University (C-LL), Graduate Institute of Clinical Medical Science, School of Medicine, College of Medicine, China Medical University (J-AL, C-HK), Department of Radiation Oncology, China Medical University Hospital (J-AL), Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung (C-HK); and Department of Internal Medicine, Zuoying Branch of Kaohsiung Armed Forces General Hospital, Kaohsiung, Taiwan (M-WW).
authors.forename: Chia-Hong
authors.initials: CH
authors.lastname: Kao
authors.forename: Li-Min
authors.initials: LM
authors.lastname: Sun
authors.forename: Yueh-Sheng
authors.initials: YS
authors.lastname: Chen
authors.forename: Cheng-Li
authors.initials: CL
authors.lastname: Lin
authors.forename: Ji-An
authors.initials: JA
authors.lastname: Liang
authors.forename: Chia-Hung
authors.initials: CH
authors.lastname: Kao
authors.forename: Ming-Wei
authors.initials: MW
authors.lastname: Weng
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D000704:Analysis of Variance; D015331:Cohort Studies; D016001:Confidence Intervals; D003430:Cross-Sectional Studies; D016208:Databases, Factual; D004938:Esophageal Neoplasms / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D019337:Hematologic Neoplasms / Q000453:epidemiology* / Q000209:etiology; D006801:Humans; D015994:Incidence; D015601:Injury Severity Score; D008113:Liver Neoplasms / Q000453:epidemiology* / Q000209:etiology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D018570:Risk Assessment; D017678:Sex Distribution; D013119:Spinal Cord Injuries / Q000150:complications* / Q000175:diagnosis; D016019:Survival Analysis; D013624:Taiwan; D014565:Urogenital Neoplasms