Subsequent risk of cancer among adults with peripheral artery disease in the community: The atherosclerosis risk in communities (ARIC) study

IF 4.3 3区材料科学 Q1 ENGINEERING, ELECTRICAL & ELECTRONIC

ACS Applied Electronic Materials Pub Date : 2024-09-19 DOI:10.1016/j.ijcard.2024.132577

Shoichiro Nohara , Yejin Mok , Jeremy R. Van't Hof , Maya Salameh , Corinne E. Joshu , Elizabeth A. Platz , Roberta Florido , Kunihiro Matsushita

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引用次数: 0

Abstract

Background and aims

Several studies reported an increased cancer risk related to lower-extremity peripheral artery disease (PAD) but had important caveats: not accounting for key confounders like smoking, follow-up <10 years, or no race-specific results. To assess the long-term independent association of PAD with cancer incidence in a bi-racial community-based cohort.

Methods

We categorized 13,106 ARIC participants without cancer at baseline (mean age 54.0 [SD 5.7] years, 45.7 % male, and 26.1 % Black) into symptomatic PAD (clinical history or intermittent claudication), asymptomatic PAD (ankle-brachial index [ABI] ≤0.9), and five ABI categories (0.1-interval between 0.9 and 1.3 and > 1.3). We used cancer registries and medical records to ascertain cancer cases and ran multivariable Cox models.

Results

During the median follow-up of 25.3 years, there were 4143 incident cancer cases. 25-year cumulative incidence was 37.2 % in symptomatic PAD, 32.3 % in asymptomatic PAD, and 28.0–31.0 % in the other categories. Symptomatic and asymptomatic PAD remained significantly associated with cancer incidence after adjusting for potential confounders, including smoking and diabetes (hazard ratio [HR] 1.42 [1.05–1.92] and 1.24 [1.05–1.46], respectively). When stratified by smoking status, we observed a robust association of PAD (symptomatic and asymptomatic combined) vs. no PAD with cancer risk in ever smokers (HR 1.42 [1.21–1.67]) but not in never smokers. The results were most evident for lung cancer (HR 2.16 (95 %CI 1.65–2.83) for PAD vs. no PAD within ever smokers).

Conclusions

Symptomatic and asymptomatic PAD conferred cancer risk, particularly among ever smokers and for lung cancer. Patients with PAD should receive evidence-based cancer prevention and screening.

查看原文本刊更多论文

社区中患有外周动脉疾病的成年人罹患癌症的后续风险：社区动脉粥样硬化风险（ARIC）研究。

背景和目的：有几项研究报告称，癌症风险增加与下肢外周动脉疾病（PAD）有关，但有一些重要的注意事项：未考虑吸烟等关键混杂因素、随访方法：我们将 13,106 名基线时未患癌症的 ARIC 参与者（平均年龄 54.0 [SD 5.7] 岁，45.7% 为男性，26.1% 为黑人）分为有症状的 PAD（临床病史或间歇性跛行）、无症状的 PAD（踝肱指数 [ABI] ≤0.9）和五个 ABI 类别（0.1-介于 0.9 和 1.3 之间以及大于 1.3）。我们利用癌症登记和医疗记录来确定癌症病例，并运行多变量 Cox 模型：中位随访 25.3 年期间，共有 4143 例癌症病例。25年的累积发病率在有症状的PAD中为37.2%，在无症状的PAD中为32.3%，在其他类别中为28.0%-31.0%。在对吸烟和糖尿病等潜在混杂因素进行调整后，无症状和无症状PAD与癌症发病率仍有显著相关性（危险比[HR]分别为1.42 [1.05-1.92]和1.24 [1.05-1.46]）。当按吸烟状况进行分层时，我们观察到在曾经吸烟者中，PAD（有症状和无症状合并）与无 PAD 与癌症风险有密切关系（HR 1.42 [1.21-1.67]），但在从不吸烟者中则没有。这一结果在肺癌中最为明显（在曾经吸烟者中，有 PAD 与无 PAD 相比，HR 为 2.16（95 %CI 为 1.65-2.83））：结论：有症状和无症状的PAD都会带来癌症风险，尤其是在曾经吸烟者和肺癌患者中。PAD患者应接受循证癌症预防和筛查。

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

ACS Applied Electronic Materials Multiple-

CiteScore

7.20

自引率

4.30%

发文量

567