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Cancer Risk in Pulmonary Hypertension Patients

BACKGROUND: Strong evidence indicates that venous thromboembolism is a presenting symptom of cancer. Cancer is a known cause of pulmonary hypertension; however, it remains unknown whether pulmonary hypertension is a marker of occult cancer. We examined the association between a pulmonary hypertensio...

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Autores principales: Sørensen, Henrik Toft, Skajaa, Nils, Klok, Frederikus Albertus, Laugesen, Kristina, Farkas, Dóra Körmendiné
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8859871/
https://www.ncbi.nlm.nih.gov/pubmed/35210864
http://dx.doi.org/10.2147/CLEP.S345054
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author Sørensen, Henrik Toft
Skajaa, Nils
Klok, Frederikus Albertus
Laugesen, Kristina
Farkas, Dóra Körmendiné
author_facet Sørensen, Henrik Toft
Skajaa, Nils
Klok, Frederikus Albertus
Laugesen, Kristina
Farkas, Dóra Körmendiné
author_sort Sørensen, Henrik Toft
collection PubMed
description BACKGROUND: Strong evidence indicates that venous thromboembolism is a presenting symptom of cancer. Cancer is a known cause of pulmonary hypertension; however, it remains unknown whether pulmonary hypertension is a marker of occult cancer. We examined the association between a pulmonary hypertension diagnosis and cancer risk in a cohort study using population-based data from the Danish health system. PATIENTS AND METHODS: Using Danish nationwide registries, we identified 6335 patients with a pulmonary hypertension diagnosis and without a previous cancer diagnosis between 1995 and 2017. We computed the age-, sex-, and calendar year-standardized incidence ratio (SIR) as the ratio of observed to expected number of cancers using national incidence rates as the reference. We performed a subgroup analysis among patients with chronic thromboembolic pulmonary hypertension in the period in which a specific ICD-10 code was available (2006–2017). RESULTS: We identified 212 cancers within the first year of follow-up and 796 cancers thereafter. The one-year risk of cancer was 3.3% and the one-year SIR was 1.96 (95% confidence interval [CI]: 1.70–2.23). In the second and subsequent years, the SIR remained elevated (SIR: 1.15 [95% CI: 1.08–1.24]). In patients with chronic thromboembolic pulmonary hypertension, the one-year SIR was 1.41 (95% CI: 0.82–2.25). CONCLUSION: Cancer risk was clearly higher in patients with pulmonary hypertension compared with the general population. The association was particularly strong in the first year of follow-up, but remained elevated thereafter. However, absolute risks were low, limiting the clinical relevance of pursuing early cancer detection in these patients.
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spelling pubmed-88598712022-02-23 Cancer Risk in Pulmonary Hypertension Patients Sørensen, Henrik Toft Skajaa, Nils Klok, Frederikus Albertus Laugesen, Kristina Farkas, Dóra Körmendiné Clin Epidemiol Short Report BACKGROUND: Strong evidence indicates that venous thromboembolism is a presenting symptom of cancer. Cancer is a known cause of pulmonary hypertension; however, it remains unknown whether pulmonary hypertension is a marker of occult cancer. We examined the association between a pulmonary hypertension diagnosis and cancer risk in a cohort study using population-based data from the Danish health system. PATIENTS AND METHODS: Using Danish nationwide registries, we identified 6335 patients with a pulmonary hypertension diagnosis and without a previous cancer diagnosis between 1995 and 2017. We computed the age-, sex-, and calendar year-standardized incidence ratio (SIR) as the ratio of observed to expected number of cancers using national incidence rates as the reference. We performed a subgroup analysis among patients with chronic thromboembolic pulmonary hypertension in the period in which a specific ICD-10 code was available (2006–2017). RESULTS: We identified 212 cancers within the first year of follow-up and 796 cancers thereafter. The one-year risk of cancer was 3.3% and the one-year SIR was 1.96 (95% confidence interval [CI]: 1.70–2.23). In the second and subsequent years, the SIR remained elevated (SIR: 1.15 [95% CI: 1.08–1.24]). In patients with chronic thromboembolic pulmonary hypertension, the one-year SIR was 1.41 (95% CI: 0.82–2.25). CONCLUSION: Cancer risk was clearly higher in patients with pulmonary hypertension compared with the general population. The association was particularly strong in the first year of follow-up, but remained elevated thereafter. However, absolute risks were low, limiting the clinical relevance of pursuing early cancer detection in these patients. Dove 2022-02-16 /pmc/articles/PMC8859871/ /pubmed/35210864 http://dx.doi.org/10.2147/CLEP.S345054 Text en © 2022 Sørensen et al. https://creativecommons.org/licenses/by-nc/3.0/This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/ (https://creativecommons.org/licenses/by-nc/3.0/) ). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php).
spellingShingle Short Report
Sørensen, Henrik Toft
Skajaa, Nils
Klok, Frederikus Albertus
Laugesen, Kristina
Farkas, Dóra Körmendiné
Cancer Risk in Pulmonary Hypertension Patients
title Cancer Risk in Pulmonary Hypertension Patients
title_full Cancer Risk in Pulmonary Hypertension Patients
title_fullStr Cancer Risk in Pulmonary Hypertension Patients
title_full_unstemmed Cancer Risk in Pulmonary Hypertension Patients
title_short Cancer Risk in Pulmonary Hypertension Patients
title_sort cancer risk in pulmonary hypertension patients
topic Short Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8859871/
https://www.ncbi.nlm.nih.gov/pubmed/35210864
http://dx.doi.org/10.2147/CLEP.S345054
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