Dement Neurocogn Disord.  2018 Dec;17(4):137-147. 10.12779/dnd.2018.17.4.137.

Association between Alzheimer's Disease and Cancer Risk in South Korea: an 11-year Nationwide Population-Based Study

Affiliations
  • 1Department of Neurology, National Health Insurance Service Ilsan Hospital, Goyang, Korea. jhlee@nhimc.or.kr
  • 2Institute of Health Insurance & Clinical Research, National Health Insurance Service Ilsan Hospital, Goyang, Korea.

Abstract

BACKGROUND AND PURPOSE
Previous studies have suggested a decreased cancer risk among patients with Alzheimer's disease (AD). There remains a lack of data on the specific types of cancer and risk factors for developing cancer in AD. We evaluated the association between AD and cancer risk, and we examined specific types of cancer.
METHODS
A population-based longitudinal study was conducted using the National Health Insurance Service-Senior cohort for 2002-2013. A total of 4,408 AD patients were included in the study, as were 19,150 matched controls. Potential associations between the risk of cancer and AD were analyzed using Cox proportional hazard regressions.
RESULTS
Cancer developed in 12.3% of the AD group patients and in 18.5% of control group subjects. AD was associated with a reduced risk of cancer (hazard ratio [HR], 0.70; 95% confidence intervals, 0.64-0.78). The risk of head and neck cancers was significantly reduced (HR, 0.49), as were risks for cancers of the digestive tract, including stomach cancer (HR, 0.42), colorectal cancer (HR, 0.61), liver and biliary tract cancers (HR, 0.68), and pancreatic cancer (HR, 0.55). Lung and prostate cancer risks were also significantly lower for the AD group (HR, 0.52 and HR, 0.72, respectively).
CONCLUSIONS
Our results showed an inverse association between AD and cancer. Further research involving a large number of patients in a hospital based-study is needed to address the biological associations between cancer development and dementia, including AD.

Keyword

Alzheimer's Disease; Epidemiology; Cancer

MeSH Terms

Alzheimer Disease*
Biliary Tract Neoplasms
Cohort Studies
Colorectal Neoplasms
Dementia
Epidemiology
Gastrointestinal Tract
Head
Humans
Korea*
Liver
Longitudinal Studies
Lung
National Health Programs
Neck
Pancreatic Neoplasms
Prostatic Neoplasms
Risk Factors
Stomach Neoplasms

Figure

  • Fig. 1 Definition of study cohorts. Among NHIS-Senior 2002–2013 data, the patients diagnosed with AD in 2002 were excluded (wash-out period). The patients diagnosed with AD (n=4,408) in the 3 years period from January 2003 to December 2005 (index period) and the control group (n=19,150) extracted using propensity score matching, were enrolled. During an 11-year follow-up period, the risk of cancers between the 2 groups was analyzed. NHIS-Senior: National Health Insurance Service-Senior, AD: Alzheimer's disease.

  • Fig. 2 Kaplan-Meier survival analysis for patients with and without AD who developed cancer. AD: Alzheimer's disease.


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