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Increased incidence of gastrointestinal cancers among patients with pyogenic liver abscess: a population-based cohort study.
Gastroenterology. 2014 Jan; 146(1):129-37.e1.G

Abstract

BACKGROUND & AIMS

The relationship between pyogenic liver abscess (PLA) and gastrointestinal (GI) cancer was first reported more than 20 years ago, yet little is known about this connection. We evaluated this association in a population-based, retrospective, cohort study.

METHODS

Using Taiwan National Health Insurance claims data, we collected data on a cohort of 14,690 patients with PLA diagnosed from 2000 to 2007. A reference cohort of 58,760 persons without PLA (controls) was selected from the same database, frequency matched by age, sex, and index year. Both cohorts were followed up until the end of 2009, and incidences of GI cancer were calculated.

RESULTS

The incidence of GI cancer was 4.30-fold higher among patients with PLA compared with controls (10.8 vs 2.51/1000 person-years). Site-specific analysis showed that the highest incidence of colorectal cancer was among patients with PLA and diabetes mellitus, followed by patients with PLA without diabetes and controls with diabetes (9.58, 5.76, and 1.49/10,000 person-years, respectively). The PLA cohort also had a high risk of small intestine cancer (adjusted hazard ratio [aHR], 12.7; 95% confidence interval [CI], 5.79-27.7) and biliary tract cancer (aHR, 9.56; 95% CI, 6.68-13.7). Their risk of pancreatic cancer (aHR, 2.51; 95% CI, 1.68-3.76) was also significant. However, patients with PLA did not have an increased risk of gastric cancer compared with controls.

CONCLUSIONS

In a population-based study, we found that the incidence of GI cancer is increased more than 4-fold among patients with PLA compared with controls. PLA might therefore be an indicator of GI cancer. Patients with PLA had the highest incidence of colorectal cancer, followed by cancers of the biliary tract, pancreas, and small intestine.

Authors+Show Affiliations

School of Chinese Medicine, China Medical University, Taichung, Taiwan; Graduate Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan; Division of Hepato-gastroenterology, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan.Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan; Department of Public Health, China Medical University, Taichung, Taiwan.Division of Hepato-gastroenterology, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan; School of Medicine, China Medical University, Taichung, Taiwan.Division of Hepato-gastroenterology, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan; School of Medicine, China Medical University, Taichung, Taiwan.Division of Hepato-gastroenterology, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan; School of Medicine, China Medical University, Taichung, Taiwan.Division of Hepato-gastroenterology, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan; School of Medicine, China Medical University, Taichung, Taiwan.School of Medicine, China Medical University, Taichung, Taiwan; Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan.Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan.Department of Public Health, China Medical University, Taichung, Taiwan; Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan. Electronic address: tw.mohd@gmail.com.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

24095786

Citation

Lai, Hsueh-Chou, et al. "Increased Incidence of Gastrointestinal Cancers Among Patients With Pyogenic Liver Abscess: a Population-based Cohort Study." Gastroenterology, vol. 146, no. 1, 2014, pp. 129-37.e1.
Lai HC, Lin CC, Cheng KS, et al. Increased incidence of gastrointestinal cancers among patients with pyogenic liver abscess: a population-based cohort study. Gastroenterology. 2014;146(1):129-37.e1.
Lai, H. C., Lin, C. C., Cheng, K. S., Kao, J. T., Chou, J. W., Peng, C. Y., Lai, S. W., Chen, P. C., & Sung, F. C. (2014). Increased incidence of gastrointestinal cancers among patients with pyogenic liver abscess: a population-based cohort study. Gastroenterology, 146(1), 129-e1. https://doi.org/10.1053/j.gastro.2013.09.058
Lai HC, et al. Increased Incidence of Gastrointestinal Cancers Among Patients With Pyogenic Liver Abscess: a Population-based Cohort Study. Gastroenterology. 2014;146(1):129-37.e1. PubMed PMID: 24095786.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Increased incidence of gastrointestinal cancers among patients with pyogenic liver abscess: a population-based cohort study. AU - Lai,Hsueh-Chou, AU - Lin,Che-Chen, AU - Cheng,Ken-Sheng, AU - Kao,Jung-Ta, AU - Chou,Jen-Wei, AU - Peng,Cheng-Yuan, AU - Lai,Shih-Wei, AU - Chen,Pei-Chun, AU - Sung,Fung-Chang, Y1 - 2013/10/03/ PY - 2012/11/06/received PY - 2013/09/23/revised PY - 2013/09/29/accepted PY - 2013/10/8/entrez PY - 2013/10/8/pubmed PY - 2014/2/19/medline KW - CI KW - Colon Cancer KW - DM KW - GI KW - HR KW - ICD-9-CM KW - Infection KW - International Classification of Diseases, Ninth Revision, Clinical Modification KW - PLA KW - Pancreas KW - Risk Factor KW - aHR KW - adjusted hazard ratio KW - confidence interval KW - diabetes mellitus KW - gastrointestinal KW - hazard ratio KW - pyogenic liver abscess SP - 129 EP - 37.e1 JF - Gastroenterology JO - Gastroenterology VL - 146 IS - 1 N2 - BACKGROUND & AIMS: The relationship between pyogenic liver abscess (PLA) and gastrointestinal (GI) cancer was first reported more than 20 years ago, yet little is known about this connection. We evaluated this association in a population-based, retrospective, cohort study. METHODS: Using Taiwan National Health Insurance claims data, we collected data on a cohort of 14,690 patients with PLA diagnosed from 2000 to 2007. A reference cohort of 58,760 persons without PLA (controls) was selected from the same database, frequency matched by age, sex, and index year. Both cohorts were followed up until the end of 2009, and incidences of GI cancer were calculated. RESULTS: The incidence of GI cancer was 4.30-fold higher among patients with PLA compared with controls (10.8 vs 2.51/1000 person-years). Site-specific analysis showed that the highest incidence of colorectal cancer was among patients with PLA and diabetes mellitus, followed by patients with PLA without diabetes and controls with diabetes (9.58, 5.76, and 1.49/10,000 person-years, respectively). The PLA cohort also had a high risk of small intestine cancer (adjusted hazard ratio [aHR], 12.7; 95% confidence interval [CI], 5.79-27.7) and biliary tract cancer (aHR, 9.56; 95% CI, 6.68-13.7). Their risk of pancreatic cancer (aHR, 2.51; 95% CI, 1.68-3.76) was also significant. However, patients with PLA did not have an increased risk of gastric cancer compared with controls. CONCLUSIONS: In a population-based study, we found that the incidence of GI cancer is increased more than 4-fold among patients with PLA compared with controls. PLA might therefore be an indicator of GI cancer. Patients with PLA had the highest incidence of colorectal cancer, followed by cancers of the biliary tract, pancreas, and small intestine. SN - 1528-0012 UR - https://www.unboundmedicine.com/medline/citation/24095786/Increased_incidence_of_gastrointestinal_cancers_among_patients_with_pyogenic_liver_abscess:_a_population_based_cohort_study_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0016-5085(13)01419-4 DB - PRIME DP - Unbound Medicine ER -