癌症相关的生存率降低:1943-2011年双胞胎大队列研究评估的程度和持续时间

IF 3.4
Martin Dalgaard Villumsen, Linda Juel Ahrenfeldt, Kaare Christensen, Marianne Ewertz, Jacob B Hjelmborg
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引用次数: 0

摘要

背景:在一项大型双胞胎研究中,对癌症幸存者死亡风险增加的时间进行了评估,该研究允许对年龄、基因和儿童时期的社会经济因素等共同成分进行匹配。方法:通过使用丹麦登记处的数据,前瞻性地研究了两种不同环境下双胞胎的初始癌症死亡时间。这对双胞胎在1943年至2011年期间被诊断出至少患有一种癌症。实验一包括5680对6岁及以上的同性双胞胎,实验二包括3218对70岁及以上的双胞胎。该研究提供了双胞胎和出生队列、诊断年龄和诊断时间的比较。结果:2001年至2011年,70岁后癌症存活的双胞胎5年死亡风险是同卵双胞胎的2倍,无论性别和合子如何,如果双胞胎存活了最初的9个月,5年死亡风险是1.5倍。5至6年后,死亡风险与同卵双胞胎相当。在过去的几十年里,老年人和年轻人的过度危险风险都要高得多。在老年出生队列中,没有迹象表明相对存活率发生了变化。结论:这项大型双胞胎研究表明,对于70岁或更晚被诊断为癌症治疗的幸存者,5年后的额外死亡风险基本上不存在,到那时,相对于同卵双胞胎的存活率为60%。影响:癌症后升高的死亡风险在5 - 6年后被抵消。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Cancer-Related Reductions in Survival: Extent and Duration Evaluated Using a Large Cohort Study of Twins, 1943-2011.

Background: The time during which there is an increased risk of death for cancer survivors was evaluated in a large twin study, which allows for matching on shared components such as age, genes, and socioeconomic factors in childhood.

Methods: By use of data from Danish registers, time to death from initial cancer was studied prospectively in twins in two different settings. The twins were diagnosed with at least one cancer in the period 1943 to 2011. Setting I included 5,680 same-sex twin pairs aged 6 and over, while Setting II included 3,218 twin individuals from age 70 and over. The study provides comparisons within twin pairs and across birth cohorts, age at diagnoses, and time at diagnosis.

Results: In 2001 to 2011, the 5-year mortality risk for a twin surviving cancer after the age of 70 was twofold that of the co-twin, regardless of sex and zygosity, and it was 1.5-fold if the twin survived the initial 9 months. After 5 to 6 years, the mortality risk corresponded to that of the co-twin. In previous decades, the excess hazard risk was considerably higher for both older and younger cohorts. There were no indications of change in relative survival across old birth cohorts.

Conclusions: This large twin study suggested that for a cancer-treatment survivor diagnosed at age 70 or later, the additional mortality risk was largely absent 5 years later, by which time the survival relative to the co-twin was 60%.

Impact: Elevated mortality risk after cancer is offset after 5 to 6 years.

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