Colorectal Cancer Risk in Patients with Hemorrhoids: A 10-Year Population-Based Retrospective Cohort Study
Abstract
:1. Introduction
2. Materials and Methods
2.1. Database
2.2. Study Population and Comorbidity
2.3. Statistical Analysis
3. Results
3.1. Demography
3.2. Higher Incidence Rates of CRC in Hemorrhoids Patients
3.3. Subgroup Analysis of Demographic Aspects and Comorbidities
3.4. Relevance of Tumor Site and Hemorrhoids
4. Discussion
5. Advantages and Limitations
6. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Variable | Hemorrhoids | Standardized Difference § | |
---|---|---|---|
No | Yes | ||
n = 36,864 | n = 36,864 | ||
Sex | n (%) | n (%) | |
Female | 17,582 (47.7) | 16,809 (45.6) | 0.04 |
Male | 19,282 (52.3) | 20,055 (54.4) | 0.04 |
Age, mean (SD) | 45.8 (15.9) | 46.9 (15.8) | 0.07 |
Stratified | |||
≤49 years | 23,569 (63.9) | 22,622 (61.4) | 0.05 |
50–64 | 7836 (21.3) | 8443 (22.9) | 0.04 |
65+ | 5459 (14.8) | 5799 (15.7) | 0.03 |
Comorbidity | |||
IBD | 566 (1.54) | 585 (1.59) | 0.004 |
Hypertension | 8580 (23.3) | 9694 (26.3) | 0.07 |
Diabetes | 2120 (5.75) | 2252 (6.11) | 0.02 |
Hyperlipidemia | 7206 (19.6) | 7263 (19.7) | 0.004 |
Stroke | 830 (2.25) | 894 (2.43) | 0.01 |
Congestive heart failure | 984 (2.67) | 1116 (3.03) | 0.02 |
Obesity | 173 (0.47) | 193 (0.52) | 0.008 |
PLA | 22 (0.06) | 23 (0.06) | 0.001 |
HBV | 1512 (4.10) | 1512 (4.10) | 0.000 |
HCV | 452 (1.23) | 505 (1.37) | 0.01 |
COPD | 3879 (10.5) | 3860 (10.5) | 0.002 |
Alcohol-related illness | 1395 (3.78) | 1397 (3.79) | 0.000 |
Chronic pancreatitis | 46 (0.12) | 62 (0.17) | 0.01 |
Variable | Hemorrhoids | Crude HR (95% CI) | Adjusted HR (95% CI) | |||||
---|---|---|---|---|---|---|---|---|
No | Yes | |||||||
Event | PY | Rate # | Event | PY | Rate # | |||
All | 138 | 255,722 | 0.54 | 337 | 261,466 | 1.29 | 2.39 (1.96, 2.93) * | 2.18 (1.78, 2.67) * |
Gender | ||||||||
Female | 52 | 113,232 | 0.46 | 128 | 121,173 | 1.06 | 2.35 (1.71, 3.25) * | 2.19 (1.59, 3.03) * |
Male | 86 | 142,490 | 0.60 | 209 | 140,293 | 1.49 | 2.38 (1.84, 3.09) * | 2.16 (1.66, 2.80) * |
Age-stratified | ||||||||
≤49 | 23 | 162,628 | 0.14 | 71 | 165,694 | 0.43 | 3.53 (2.15, 5.79) * | 3.53 (2.15, 5.79) * |
50–64 | 45 | 55,159 | 0.82 | 113 | 57,499 | 1.97 | 1.95 (1.39, 2.73) * | 1.91 (1.36, 2.68) * |
65+ | 70 | 37,935 | 1.85 | 153 | 38,272 | 4.00 | 2.12 (1.58, 2.85) * | 2.06 (1.53, 2.77) * |
Comorbidity | ||||||||
No | 54 | 161,577 | 0.33 | 98 | 149,717 | 0.65 | 2.58 (1.79, 3.72) * | 2.53 (1.76, 3.66) * |
Yes | 84 | 94,145 | 0.89 | 239 | 111,749 | 2.14 | 2.13 (1.67, 2.72) * | 2.09 (1.64, 2.67) * |
Site of CRC | Hemorrhoids | Crude HR (95% CI) | Adjusted HR (95% CI) | |||
---|---|---|---|---|---|---|
No | Yes | |||||
Event | Rate # | Event | Rate # | |||
Ascending colon (ICD-9-CM 153.0, 153.4-6) | 13 | 0.05 | 21 | 0.08 | 1.49 (0.75, 2.97) | 1.34 (0.67, 2.69) |
Transverse colon (ICD-9-CM 153.1) | 4 | 0.02 | 5 | 0.02 | 1.18 (0.32, 4.41) | 1.08 (0.29, 4.07) |
Descending colon (ICD-9-CM 153.2, 153.7) | 3 | 0.01 | 10 | 0.04 | 3.13 (0.86, 11.4) | 2.83 (0.78, 10.3) |
Sigmoid colon (ICD-9-CM 153.3) | 21 | 0.08 | 43 | 0.17 | 1.92 (1.14, 3.24) * | 1.79 (1.06, 3.02) * |
Rectum (ICD-9-CM 154.0-1) | 34 | 0.14 | 86 | 0.33 | 2.40 (1.61, 3.57) ** | 2.20 (1.48, 3.28) ** |
Other (ICD-9-CM 153.8-9, 154.2-3, 154.8) | 18 | 0.07 | 39 | 0.15 | 2.08 (1.19, 3.64) | 1.86 (1.06, 3.26) |
Unknown | 45 | 0.17 | 133 | 0.51 | 2.99 (1.97, 3.66) ** | 2.76 (1.85, 3.67) ** |
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Wu, E.-B.; Sung, F.-C.; Lin, C.-L.; Wu, K.-L.; Chen, K.-B. Colorectal Cancer Risk in Patients with Hemorrhoids: A 10-Year Population-Based Retrospective Cohort Study. Int. J. Environ. Res. Public Health 2021, 18, 8655. https://doi.org/10.3390/ijerph18168655
Wu E-B, Sung F-C, Lin C-L, Wu K-L, Chen K-B. Colorectal Cancer Risk in Patients with Hemorrhoids: A 10-Year Population-Based Retrospective Cohort Study. International Journal of Environmental Research and Public Health. 2021; 18(16):8655. https://doi.org/10.3390/ijerph18168655
Chicago/Turabian StyleWu, En-Bo, Fung-Chang Sung, Cheng-Li Lin, Kuen-Lin Wu, and Kuen-Bao Chen. 2021. "Colorectal Cancer Risk in Patients with Hemorrhoids: A 10-Year Population-Based Retrospective Cohort Study" International Journal of Environmental Research and Public Health 18, no. 16: 8655. https://doi.org/10.3390/ijerph18168655