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Cholangitis and subsequent gastrointestinal cancer risk: a Danish population-based cohort study.

https://arctichealth.org/en/permalink/ahliterature112739
Source
Gut. 2014 Feb;63(2):356-61
Publication Type
Article
Date
Feb-2014
Author
Kirstine Kobberøe Søgaard
Rune Erichsen
Jennifer Leigh Lund
Dóra Körmendiné Farkas
Henrik Toft Sørensen
Author Affiliation
Department of Clinical Epidemiology, Aarhus University Hospital, , Aarhus, Denmark.
Source
Gut. 2014 Feb;63(2):356-61
Date
Feb-2014
Language
English
Publication Type
Article
Keywords
Aged
Cholangitis - complications
Cohort Studies
Denmark - epidemiology
Female
Follow-Up Studies
Gastrointestinal Neoplasms - epidemiology - etiology
Humans
Incidence
Male
Middle Aged
Registries
Risk assessment
Risk factors
Abstract
While patients with gastrointestinal cancer are at increased risk of cholangitis, it is less clear whether cholangitis is also a marker for occult gastrointestinal cancer. If an undiagnosed cancer obstructs the bile duct system and causes cholangitis, the short-term risk of cancer will appear increased. However, an increased long-term risk of cancer may originate from chronic inflammatory processes. We assessed the risk of a gastrointestinal cancer diagnosis subsequent to a cholangitis diagnosis during a 17-year period in Denmark.
We conducted a nationwide population-based cohort study by linking Danish medical registries during 1994-2010. We quantified the excess risk of cancer in cholangitis patients using relative (standardised incidence ratio; SIR) and absolute (excess absolute risk per 1000 person-years at risk; EAR) risk calculations.
4333 patients with cholangitis (including 178 with primary sclerosing cholangitis) were followed for 17 222 person-years. During the follow-up period, 477 gastrointestinal cancers occurred versus 59 expected, corresponding to a SIR of 8.12 (95% CI 7.41 to 8.88). Risk was increased mainly for cancer in the small intestine (SIR 18.2; 95% CI 8.69 to 33.4), liver (SIR 16.3; 95% CI 11.6 to 22.2), gallbladder and biliary tract (SIR 70.9; 95% CI 59.0 to 84.4) and pancreas (SIR 31.7; 95% CI 27.8 to 36.0). During the first 6 months of follow-up, 314 patients were diagnosed with gastrointestinal cancer, corresponding to a SIR of 49.8 (95% CI 44.4 to 55.6) and an EAR of 175.
Cholangitis is a marker of occult gastrointestinal cancer.
PubMed ID
23804559 View in PubMed
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Pericarditis as a Marker of Occult Cancer and a Prognostic Factor for Cancer Mortality.

https://arctichealth.org/en/permalink/ahliterature285943
Source
Circulation. 2017 Sep 12;136(11):996-1006
Publication Type
Article
Date
Sep-12-2017
Author
Kirstine Kobberøe Søgaard
Dóra Körmendiné Farkas
Vera Ehrenstein
Krishnan Bhaskaran
Hans Erik Bøtker
Henrik Toft Sørensen
Source
Circulation. 2017 Sep 12;136(11):996-1006
Date
Sep-12-2017
Language
English
Publication Type
Article
Keywords
Adult
Aged
Cohort Studies
Databases, Factual - trends
Denmark - epidemiology
Follow-Up Studies
Humans
Middle Aged
Mortality - trends
Neoplasms - diagnosis - mortality
Pericarditis - diagnosis - mortality
Prognosis
Registries
Abstract
Pericarditis may be a serious complication of malignancy. Its significance as a first symptom of occult cancer and as a prognostic factor for cancer survival is unknown.
Using Danish medical databases, we conducted a nationwide cohort study of all patients with a first-time diagnosis of pericarditis during 1994 to 2013. We excluded patients with previous cancer and followed up the remaining patients for subsequent cancer diagnosis until November 30, 2013. We calculated risks and standardized incidence ratios of cancer for patients with pericarditis compared with the general population. We assessed whether pericarditis predicts cancer survival by the Kaplan-Meier method and Cox regression using a matched comparison cohort of cancer patients without pericarditis.
Among 13 759 patients with acute pericarditis, 1550 subsequently were diagnosed with cancer during follow-up. The overall cancer standardized incidence ratio was 1.5 (95% confidence interval [CI], 1.4-1.5), driven predominantly by increased rates of lung, kidney, and bladder cancer, lymphoma, leukemia, and unspecified metastatic cancer. The
PubMed ID
28663234 View in PubMed
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