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The Risk of Cancer in Patients with Benign Anal Lesions: A Nationwide Population-based Study - 19/11/13

Doi : 10.1016/j.amjmed.2013.05.016 
Pei-Chang Lee, MD a, 1, Yu-Wen Hu, MD b, c, d, 1, Man-Hsin Hung, MD e, Chun-Chia Chen, MD a, b, Han-Chieh Lin, MD a, b, Fa-Yauh Lee, MD a, b, Yi-Ping Hung, MD e, Vincent Yi-Fong Su, MD f, Sang-Hue Yen, MD b, c, g, Cheng-Hwai Tzeng, MD b, e, Tzeon-Jye Chiou, MD b, e, Chia-Jen Liu, MD b, d, e, h, ⁎
a Division of Gastroenterology, Department of Medicine, Taipei Veterans General Hospital, Taiwan 
b School of Medicine, National Yang-Ming University, Taipei, Taiwan 
c Cancer Center, Taipei Veterans General Hospital, Taiwan 
d Institute of Public Health, National Yang-Ming University, Taipei, Taiwan 
e Division of Hematology and Oncology, Department of Medicine, Taipei Veterans General Hospital, Taiwan 
f Department of Chest Medicine, Taipei Veterans General Hospital, Taiwan 
g Department of Biomedical Imaging and Radiological Sciences, National Yang-Ming University Hospital, Yilan, Taiwan 
h Department of Internal Medicine, National Yang-Ming University Hospital, Yilan, Taiwan 

∗Requests for reprints should be addressed to Chia-Jen Liu, MD, Division of Hematology and Oncology, Department of Medicine, Taipei Veterans General Hospital, No. 201, Sec. 2, Shipai Rd., Beitou District, Taipei 11217, Taiwan.

Abstract

Objective

To evaluate the risk of cancer among patients diagnosed with hemorrhoids and benign anal inflammatory lesions.

Methods

A population-based, retrospective cohort study was conducted that included patients diagnosed with hemorrhoids or benign inflammatory anal lesions (eg, anal fissure, fistula, and perianal abscesses) that were registered in the National Health Insurance Research Database in Taiwan between January 1, 2000 and December 31, 2010. Standardized incidence ratios (SIRs) were calculated to compare the cancer incidence of these patients to the general population.

Results

During a median observation period of 6.23 years, 3080 cancers developed among 70,513 hemorrhoid patients, with a follow-up period of 438,425.6 person-years, entailing the SIR of 1.52 (95% confidence interval [CI], 1.47-1.58). Increased cancer risk (SIR 1.16; 95% CI, 1.11-1.21) was still noted even after excluding the first year of observation. Significant long-term risk for colorectal cancer (SIR 1.50; 95% CI, 1.35-1.66) and prostate cancer (SIR 1.40; 95% CI, 1.17-1.66) was observed after corrections were made for multiple comparisons. In contrast, there was no remarkable increase in cancer risk for patients with inflammatory anal lesions when cancers detected within the first year of diagnosis were excluded.

Conclusion

The presence of hemorrhoids is associated significantly with a long-term risk of developing colorectal cancer or prostate cancer. In contrast, benign inflammatory anal lesions do not appear to increase the risk of malignancy.

El texto completo de este artículo está disponible en PDF.

Keywords : benign anal lesions, hemorrhoids, cancer risk


Esquema


 Funding: This study is partly supported by a grant from Taipei Veterans General Hospital (V102D-001-1).
 Conflict of Interest: None.
 Authorship: Study concepts and design: P-CL, Y-WH, C-JL; data acquisition: Y-WH, C-JL, HY-P, VY-FS; quality control of data & algorithm: H-CL, F-YL, S-HY, C-HT, T-JC; data analysis and interpretation: P-CL, Y-WH, C-JL, M-HH; statistical analysis: Y-WH, C-JL; manuscript preparation: P-CL, M-HH, C-CC, M-HH, VY-FS; manuscript editing: P-CL, Y-WH, C-JL; manuscript review & correction: C-CC, H-CL, F-YL, S-HY, C-HT, T-JC.


© 2013  Elsevier Inc. Reservados todos los derechos.
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Vol 126 - N° 12

P. 1143.e9-1143.e18 - décembre 2013 Regresar al número
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