咽鳞状细胞癌和后期食管鳞状细胞癌的风险-一项全国性的基于人群的匹配病例对照研究

IF 2.4 3区医学 Q3 ONCOLOGY

Cancer Epidemiology Pub Date : 2025-07-15 DOI:10.1016/j.canep.2025.102876

Peter Elbe , Isabella Ekheden , Miroslav Vujasinovic , John Maret-Ouda , Elin Marsk , Marcus Thuresson , Weimin Ye , Jonas F. Ludvigsson

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引用次数: 0

摘要

咽部鳞状细胞癌与后来的食管鳞状细胞癌有关，但尚不清楚其风险是否与Barrett食管相似，是否有必要进行常规胃镜检查。方法通过瑞典28个病理科室的组织病理学报告检索1980-2016年咽癌和食管癌的数据，并与全国人口卫生保健登记册相关联。我们计算了咽癌患者与匹配的一般人群相比食管癌和死亡的风险比（hr），并在二次分析中与患者的兄弟姐妹进行了比较。结果我们确定了1055例没有既往或合并癌症的咽喉癌成人患者。78 %为男性，诊断咽喉癌时的中位年龄为64岁。在中位随访2.5年期间，4例（0.4 %）患者发生食管鳞状细胞癌，相当于263例患者中有1例(HR = 14.3；95 % ci = 1.6-132.3)。在竞争风险分析中，ESCC的风险估估值下降，没有达到统计学意义（亚分布HR=1.9(95 % CI= 0.7-5.2)）。随访期间约有855名患者（81% %）死亡，咽癌患者的死亡风险增加了7.7倍(Cox回归：HR=7.7；95 % ci = 6.8-8.6)。结论食管癌的年发病风险为0.07 %。这比巴雷特食管低，因此反对在咽癌患者中进行长期内窥镜检查。证据水平

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Pharyngeal squamous cell carcinoma and risk of later esophageal squamous cell carcinoma – A nationwide population-based matched case-control study

Background

Pharyngeal squamous cell carcinoma has been linked to later squamous cell carcinoma of the esophagus, but it is unclear if risks are similar to that of Barrett’s esophagus and would justify routine gastroscopy surveillance.

Method

Data on pharyngeal and esophageal cancers in 1980–2016 were retrieved through histopathology reports from Sweden’s 28 pathology departments and linked to national population-based healthcare registers. We calculated hazard ratios (HRs) for esophageal cancer and death in patients with pharyngeal carcinoma compared to a matched general population, and in a secondary analysis also compared to siblings of patients.

Results

We identified 1055 adults with pharyngeal cancer without prior or concomitant cancer. 78 % were men and median age at diagnosis of pharyngeal cancer was 64 years. During a median follow-up of 2.5 years four (0.4 %) patients developed esophageal squamous cell carcinoma, equal to 1 in 263 patients (HR = 14.3; 95 % CI = 1.6–132.3). In a competing risk analysis, the risk estimate for ESCC dropped and did not attain statistical significance (subdistribution HR=1.9 (95 % CI=0.7–5.2)). Some 855 patients (81 %) died during follow-up, representing a 7.7-fold increased risk of death among patients with pharyngeal cancer (Cox regression: HR=7.7; 95 % CI = 6.8–8.6).

Conclusion

The yearly risk of developing esophageal squamous cell carcinoma was 0.07 %. This is lower than in Barrett’s esophagus and argues against long-term endoscopic surveillance among patients with pharyngeal cancer.

Level of Evidence

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来源期刊

Cancer Epidemiology 医学-肿瘤学

CiteScore

4.50

自引率

3.80%

发文量

200

审稿时长

39 days

期刊介绍： Cancer Epidemiology is dedicated to increasing understanding about cancer causes, prevention and control. The scope of the journal embraces all aspects of cancer epidemiology including: • Descriptive epidemiology • Studies of risk factors for disease initiation, development and prognosis • Screening and early detection • Prevention and control • Methodological issues The journal publishes original research articles (full length and short reports), systematic reviews and meta-analyses, editorials, commentaries and letters to the editor commenting on previously published research.