Risk of malignancies and chemopreventive effect of statin, metformin, and aspirin in Korean patients with ulcerative colitis: a nationwide population-based study.

IF 3.4 Q2 GASTROENTEROLOGY & HEPATOLOGY Intestinal Research Pub Date : 2023-11-09 DOI:10.5217/ir.2023.00062

Eun Hye Oh, Ye-Jee Kim, Minju Kim, Seung Ha Park, Tae Oh Kim, Sang Hyoung Park

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Abstract

Background/aims: We investigated the incidences of overall and site-specific malignancies and chemopreventive effects of statin, metformin, and aspirin in patients with ulcerative colitis.

Methods: We collected data using the Health Insurance Review and Assessment claims database from January 2007 to April 2020.

Results: The overall malignancy risk among the 35,189 ulcerative colitis patients was similar to that of the general population (standardized incidence ratio, 0.94; 95% confidence interval, 0.88-1.00). In male patients, standardized incidence ratios were high for thyroid cancer and low for stomach cancer, colorectal cancer, liver cancer, and lung cancer. Concurrently, standard incidence ratios were high for liver cancer and central nervous system cancer in female patients. While 122 cases of colorectal cancer occurred in the study patients, the standardized incidence ratio was 0.83 (95% confidence interval, 0.69-0.99). Treatment for ulcerative colitis was not associated with an increased adjusted hazard ratio, while comorbidities increased it for all malignancies. Treatment for ulcerative colitis was associated with an increased adjusted hazard ratio, while comorbidities did not increase it for colorectal cancer. After adjusting for age, sex, comorbidities, and ulcerative colitis treatment, statins showed a dose-dependent chemopreventive effect for all malignancies (P=0.002), while metformin and aspirin did not show any.

Conclusions: In ulcerative colitis patients, standardized incidence ratios for all malignancies and colorectal cancer did not increase. Adjusted hazard ratios for all malignancies increased with comorbidities and those for colorectal cancer with ulcerative colitis treatment. Statins have a dose-dependent chemopreventive effect for all malignancies.

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韩国溃疡性结肠炎患者的恶性肿瘤风险和他汀类药物、二甲双胍和阿司匹林的化学预防作用：一项基于全国人群的研究。

背景/目的：我们研究了溃疡性结肠炎患者的整体和特异性恶性肿瘤的发生率以及他汀类药物、二甲双胍和阿司匹林的化学预防作用。方法：我们使用健康保险审查和评估索赔数据库收集了2007年1月至2020年4月的数据。结果：35189名溃疡性结肠炎患者的总体恶性肿瘤风险与普通人群相似（标准化发病率为0.94；95%置信区间为0.88-1.00）。在男性患者中，甲状腺癌症的标准化发病率较高，癌症、癌症、癌症和癌症的标准化患病率较低。同时，女性患者中癌症和中枢神经系统癌症的标准发病率较高。虽然研究患者中发生了122例结直肠癌癌症，但标准化发病率为0.83（95%置信区间，0.69-0.99）。溃疡性结肠炎的治疗与调整后的风险比增加无关，而所有恶性肿瘤的合并症都会增加。溃疡性结肠炎的治疗与调整后的风险比增加相关，而合并症并没有增加癌症的风险比。在调整了年龄、性别、合并症和溃疡性结肠炎治疗后，他汀类药物对所有恶性肿瘤都表现出剂量依赖性的化学预防作用（P=0.002），而二甲双胍和阿司匹林则没有表现出任何作用。结论：在溃疡性结肠炎患者中，所有恶性肿瘤和结直肠癌癌症的标准化发病率没有增加。所有恶性肿瘤的调整后风险比随着合并症的增加而增加，而癌症溃疡性结肠炎治疗的风险比则增加。他汀类药物对所有恶性肿瘤具有剂量依赖性的化学预防作用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Intestinal Research GASTROENTEROLOGY & HEPATOLOGY-

CiteScore

7.40

自引率

10.20%

发文量

审稿时长

38 weeks

期刊介绍： Intestinal Research (Intest Res) is the joint official publication of the Asian Organization for Crohn''s and Colitis (AOCC), Chinese Society of IBD (CSIBD), Japanese Society for IBD (JSIBD), Korean Association for the Study of Intestinal Diseases (KASID), Taiwan Society of IBD (TSIBD) and Colitis Crohn''s Foundation (India) (CCF, india). The aim of the Journal is to provide broad and in-depth analysis of intestinal diseases, especially inflammatory bowel disease, which shows increasing tendency and significance. As a Journal specialized in clinical and translational research in gastroenterology, it encompasses multiple aspects of diseases originated from the small and large intestines. The Journal also seeks to propagate and exchange useful innovations, both in ideas and in practice, within the research community. As a mode of scholarly communication, it encourages scientific investigation through the rigorous peer-review system and constitutes a qualified and continual platform for sharing studies of researchers and practitioners. Specifically, the Journal presents up-to-date coverage of medical researches on the physiology, epidemiology, pathophysiology, clinical presentations, and therapeutic interventions of the intestinal diseases. General topics of interest include inflammatory bowel disease, colon and small intestine cancer or polyp, endoscopy, irritable bowel syndrome and other motility disorders, infectious enterocolitis, intestinal tuberculosis, and so forth. The Journal publishes diverse types of academic materials such as editorials, clinical and basic reviews, original articles, case reports, letters to the editor, brief communications, perspective, statement or commentary, and images that are useful to clinicians and researchers.