학술논문

Cancer Risk in Patients with Down Syndrome—A Retrospective Cohort Study from Germany.
Document Type
Article
Source
Cancers. Mar2024, Vol. 16 Issue 6, p1103. 11p.
Subject
*TUMOR risk factors
*RISK assessment
*DOWN syndrome
*PRIMARY health care
*EARLY detection of cancer
*CANCER patients
*RETROSPECTIVE studies
*DESCRIPTIVE statistics
*LONGITUDINAL method
*KAPLAN-Meier estimator
*LOG-rank test
*MEDICAL records
*ACQUISITION of data
*STATISTICS
*TUMORS
*COMPARATIVE studies
*ATTRIBUTION (Social psychology)
*CONFIDENCE intervals
*MEDICAL practice
*DISEASE incidence
*PROPORTIONAL hazards models
*REGRESSION analysis
*DISEASE complications
TUMOR prevention
Language
ISSN
2072-6694
Abstract
Simple Summary: Individuals with Down syndrome (DS) are thought to have a unique tumor profile. This study retrospectively compared patients with DS aged ≥18 years from primary care practices with patients without DS between 2005 and 2021 for cancer incidence after matching for age, sex, average annual visit frequency, and comorbidity. The 5-year cumulative incidence of cancer overall and specific cancers was analyzed using Kaplan–Meier curves and compared using the log-rank test. In addition, univariable Cox regression analysis was performed. A total of 2438 patients with DS and 12,190 patients without DS were included. Regression analysis showed no significant association between DS and subsequent cancer in the overall population. Analyses by cancer type and sex showed a strong but non-significant negative association between DS and breast cancer in women. Our results may provide the basis for future studies to clarify whether and to what extent an adapted screening program needs to be modified for individuals with Down syndrome due to the particular cancer distribution pattern. Background: Individuals with Down syndrome are thought to have a unique tumor profile. Methods: Using the IQVIA Disease Analyzer database, patients aged ≥18 years diagnosed with Down syndrome in German general practices between 2005 and 2021 were compared with patients without Down syndrome for cancer incidence, adjusting for age, sex, average annual visit frequency, and comorbidity. The 5-year cumulative incidence of cancer overall and specific cancers was analyzed using Kaplan–Meier curves and compared using the log-rank test. In addition, univariable Cox regression analysis was performed. Results: A total of 2438 patients with Down syndrome and 12,190 patients without Down syndrome were included; 3.9% of patients without Down syndrome and 3.1% of patients with Down syndrome were diagnosed with cancer (p = 0.143). Regression analysis showed no significant association between Down syndrome and subsequent cancer in the total population (HR: 0.79; 95% CI: 0.57–1.09), in women (HR: 0.89; 95% CI: 0.56–1.37), or in men (HR: 0.69; 95% CI: 0.43–1.11). Analyses by cancer type and sex showed a strong but not significant negative association between Down syndrome and breast cancer in women (HR: 0.33; 95% CI: 0.12–0.93). Conclusions: Our results could form the basis for future studies to clarify whether and to what extent an adapted screening program needs to be modified for individuals with Down syndrome due to the particular cancer distribution pattern. [ABSTRACT FROM AUTHOR]