Publications (22)86.52 Total impact
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Article: A nationwide population-based retrospective cohort study: decreased risk of stroke in cervical cancer patients after receiving treatment.
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ABSTRACT: OBJECTIVE: To evaluate risk of stroke in patients with cervical cancer using population-based data. METHODS: Claims collected in the Taiwan National Health Insurance database were used to identify 20,286 cervical cancer patients receiving diagnosis and treatment during 2000-2008. A reference group of 81,144 non-cancer participants, matched for age, cervical cancer-month and cervical cancer-year, was used for comparison. Risk of stroke was further assessed at follow-up until the end of 2009. RESULTS: Patients with cervical cancer had a 42 % lower risk of developing stroke compared with the cancer-free reference population. Increased risk of stroke was observed in patients receiving radiotherapy compared with the surgery treatment group (HR = 1.88, 95 % CI = 1.52-2.32). CONCLUSION: Results from this large retrospective cohort study indicate a lower risk of developing stroke in cervical cancer patients after receiving treatment compared with a reference population free of cancer after adjusted for age, sex, urbanization level, and stroke risk factors including hypertension and diabetes. Supplementation of estrogen after cancer treatment could explain this finding. Further prospective randomized controlled analysis is needed to confirm these findings and to elucidate the underlying biological mechanisms.Archives of Gynecology 04/2013; · 0.91 Impact Factor -
Article: Risk of Coronary Artery Disease is Not Linked to Head and Neck Cancers: A Population Based Retrospective Cohort Study.
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ABSTRACT: Objectives: To explore the possible association between the risk of coronary artery disease and head or neck cancers based on some possible shared risk factors and/or treatment-related complications. Design and Setting: A population based retrospective cohort Study. Participants: All new 729 head and neck cancer patients diagnosed between 2000 and 2003 were followed up till 2009 and the risk of subsequent coronary artery disease calculated. For each patient the risk was calculated in 4 age and sex matched population controls. Matching was not possible for factors including socio-economic group and smoking. Main outcome measures: Cox's proportional hazard regression analysis was conducted to estimate the relationship between head or neck cancers and risk of coronary artery disease. Results: For patients with head or neck cancer, the overall risk for developing coronary artery disease was almost the same as that of the control group [adjusted hazard ratio (but without control for some lifestyle factors): 0.95; 95% confidence interval: 0.65 - 1.35]. Overall, we found no increased risk of coronary artery disease for patients with head or neck cancer when the data were categorized either by treatment methods or by cancer subsites. Conclusions: This population-based study indicated that patients with head or neck cancer were at no higher risk of developing coronary artery disease than was the general population over a 6-9 year period; however, we cannot exclude the risk over a longer period of time. © 2012 Blackwell Publishing Ltd.Clinical otolaryngology: official journal of ENT-UK; official journal of Netherlands Society for Oto-Rhino-Laryngology & Cervico-Facial Surgery 08/2012; · 2.39 Impact Factor -
Article: A population-based nested case-control study in taiwan: use of 5α-reductase inhibitors did not decrease prostate cancer risk in patients with benign prostate hyperplasia.
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ABSTRACT: 5α-Reductase inhibitors (5ARIs) are commonly used to treat benign prostate hyperplasia (BPH) by blocking the conversion of testosterone into the more potent dihydrotestosterone. This study explored a possible association between the use of the 5ARIs finasteride and dutasteride and the subsequent risk of prostate cancer or other cancers. We analyzed data from the Taiwanese National Health Insurance system. In a BPH cohort, we identified 1,489 patients with cancer and included them in our study group. For the control group, 3 patients without cancer were frequency matched with each BPH case for age, BPH diagnosis year, index year, and month. Information regarding past 5ARI use was obtained from the Taiwanese National Health Insurance Research Database (NHIRD). Multivariate logistic regression analysis was conducted, and odds ratio (OR) and 95% confidence interval (CI) were estimated. Finasteride use marginally increased the incidence of prostate and overall cancer at a level of statistical significance (prostate cancer: OR = 1.90; 95% CI: 1.00-3.59; overall cancer: OR = 1.51; 95% CI: 1.00-2.28). Dutasteride use significantly increased kidney cancer risk (OR = 9.68, 95% CI: 1.17-80.0). Dosage analysis showed that lower doses of finasteride were associated with higher overall and prostate cancer risks. The major limitation is the lack of important data in the NHIRD, such as prostate cancer histologic grades, smoking habits, alcohol consumption, body mass index, socioeconomic status, and family history of cancer. This population-based nested case-control study suggested that finasteride use may increase prostate and overall cancer risks for patients with BPH. The effects were more prominent for patients using lower doses of finasteride.The Oncologist 06/2012; 17(7):986-91. · 3.91 Impact Factor -
Article: Estrogen decrease coronary artery disease risk in patients with cervical cancer after treatment.
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ABSTRACT: The purpose of this study was to explore the possible association between coronary artery disease (CAD) risk and cervical cancer. We used data from the National Health Insurance system of Taiwan to address the research topic. The exposure cohort contained 728 patients with cervical cancer. Each cancer patient was randomly frequency-matched with 4 participants by age, index-month, and index-year from the general population who did not have a cancer history before the index date (control group). Cox's proportion hazard regression analyses were conducted to estimate the relationship between cervical cancer and CAD risk. Among patients with cervical cancer, the overall risk for developing CADs was significantly lower than that of the control group [adjusted hazard ratio (aHR): 0.57, 95% confidence interval (95% CI): 0.41-0.79]. Further analyses revealed that the lower risk was observed only in patients with older age (aHR: 0.57, 95% CI: 0.40-0.82), a shorter follow-up duration (aHR: 0.47, 95% CI: 0.31-0.72), or with estrogen supplements (aHR: 0.39, 95% CI: 0.22-0.68). The findings from this population-based study suggest that estrogen supplements are associated with a decreased CAD risk in patients with cervical cancer.Gynecologic Oncology 06/2012; 127(1):186-90. · 3.89 Impact Factor -
Article: Association of Hepatitis C Virus Infection With Risk of ESRD: A Population-Based Study.
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ABSTRACT: The association between chronic hepatitis C virus (HCV) infection and end-stage renal disease (ESRD) has been widely debated. National population-based cohort study. Insurance claims data from the Taiwan National Health Insurance Research Database in 2000-2005. Chronic HCV infection as defined by the International Classification of Diseases, Ninth Revision, Clinical Modification. ESRD as defined by the International Classification of Diseases, Ninth Revision, Clinical Modification. We identified 6,291 adults with chronic HCV infection. The control group included 31,455 sex- and age-matched individuals without evidence of chronic hepatitis. The incidence of ESRD was 2.14-fold higher in patients with chronic HCV infection (HR, 1.53; 95% CI, 1.17-2.01; P = 0.002) than in patients without HCV infection. Age stratification analysis showed that patients aged 50-59 years with chronic HCV infection (HR, 7.77; 95% CI, 4.23-14.3; P < 0.001) had the highest risk of developing ESRD relative to patients aged 20-49 years without chronic HCV infection (interaction P < 0.001). Lack of clinical data. Patients with chronic HCV infection are at greater risk of developing ESRD than individuals without chronic HCV infection. In addition, the risk of developing ESRD is highest in younger patients with HCV infection. Early renal screening programs should be initiated for this high-risk group of young individuals with chronic HCV infection.American Journal of Kidney Diseases 05/2012; 60(4):553-60. · 5.43 Impact Factor -
Article: Relationship of zolpidem and cancer risk: a Taiwanese population-based cohort study.
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ABSTRACT: To evaluate the relationship between the use of zolpidem and subsequent cancer risk in Taiwanese patients. We used data from the National Health Insurance system of Taiwan to investigate whether use of zolpidem was related to cancer risk. For the study cohort, we identified 14,950 patients who had received a first prescription for zolpidem from January 1, 1998, through December 31, 2000. For each zolpidem user, we selected randomly 4 comparison patients without a history of using zolpidem who were frequency-matched by sex, age, and year of the index date. Incidence rates of all cancers and selected site-specific cancers were measured by the end of 2009, and related hazard ratios (HRs) and 95% confidence intervals (CIs) of the cancer were measured as well. The risk of developing any cancer was greater in patients using zolpidem than in nonusers (HR, 1.68; 95% CI, 1.55-1.82). The stratified analysis showed that the overall HR for high-dosage zolpidem (≥300 mg/y) was 2.38. The site-specific cancer risk was the highest for oral cancer (HR, 2.36; 95% CI, 1.57-3.56), followed by kidney cancer, esophageal cancer, breast cancer, liver cancer, lung cancer, and bladder cancer (HR, 1.60; 95% CI, 1.06-2.41). Men were at higher risk than women. This population-based study revealed some unexpected findings, suggesting that the use of zolpidem may be associated with an increased risk of subsequent cancer. Further large-scale and in-depth investigations in this area are warranted.Mayo Clinic Proceedings 05/2012; 87(5):430-6. · 5.70 Impact Factor -
Article: Modest increase in risk of specific types of cancer types in type 2 diabetes mellitus patients.
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ABSTRACT: Most studies associated diabetes mellitus (DM) with risk of cancer have focused on the Caucasian population and only a few types of cancer. Therefore, a large and comprehensive nationwide retrospective cohort study involving an Asian population was conducted to evaluate the risk of several major types of cancer among Type 2 DM patients. The study analyzed the nationwide population-based database from 1996 to 2009 released by the National Health Research Institute in Taiwan. Incidence and hazard ratios (HRs) were calculated for specific types of cancer. The overall risk of cancers was significantly greater in the DM cohort [N = 895,434; HR = 1.19, 95% confidence interval (CI) = 1.17-1.20], compared with non-DM controls (N = 895,434). Several organs in the digestive and urogenital systems showed increased risk of cancer. The three highest HRs were obtained from cancers of the liver (HR = 1.78, 95% CI = 1.73-1.84), pancreatic (HR = 1.52, 95% CI = 1.40-1.65), and uterus and corpus (HR = 1.38, 95% CI = 1.22-1.55). The risk increased with age, and men with DM aged ≥75 years exhibited the highest risk (HR = 7.76, 95% CI = 7.39-8.15). Subjects with DM in this population have a modest increased risk of cancer, similar to the Caucasian population for several specific types of cancer. Old men with DM have the highest risk of cancer. Careful screening for cancer in DM patients is important for early diagnosis and effective treatment.International Journal of Cancer 04/2012; · 5.44 Impact Factor -
Article: Non-apnea sleep disorders will increase subsequent liver cancer risk--a nationwide population-based cohort study.
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ABSTRACT: It is well known that patients with sleep disorders (SD) have an increased risk of cardiovascular disease, diabetes mellitus, obesity, and total mortality. However, little information exists regarding the relationship between non-apnea SD and the risk of cancer. The goal of this study was to determine if any association between SD and malignancy exists in Taiwan. We used data from the National Health Insurance system of Taiwan to assess this issue. The SD cohort contained 42,351 patients, and each patient was randomly frequency-matched by age and sex with two people from the general population without SD. The Cox's proportional hazard regression analysis was conducted to estimate the effects of SD on cancer risk. In patients with SD, the overall risk of developing cancer was significantly higher than in normal healthy subjects (adjusted Hazard ratio [HR]=1.12, 95% confidence interval=1.06-1.18). This held true even when we analyzed males and females separately. In regards to individual types of cancer, the risk for developing liver cancer among patients with SD was significantly higher than in subjects without SD. For breast cancer the risk showed a marginally significant increase. The nationwide population-based cohort study found Taiwanese patients with SD have a higher risk of developing cancer, particularly liver cancer and, possibly, breast cancer.Sleep Medicine 04/2012; 13(7):869-74. · 3.40 Impact Factor -
Article: Benzodiazepine use possibly increases cancer risk: a population-based retrospective cohort study in Taiwan.
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ABSTRACT: To evaluate the possible association between benzodiazepine use and subsequent cancer risk in Taiwan. In this population-based retrospective cohort study, we used data from 1996 to 2000 from the Taiwanese National Health Insurance system to investigate the possible association between benzodiazepine use and cancer risk. The exposure cohort (mean age = 47.9 years, standard deviation [SD] = 17.3 years) consisted of 59,647 patients with benzodiazepine use. Each patient from the exposure cohort was randomly frequency-matched by age and sex to a person from the cohort with no benzodiazepine exposure (the comparison group; mean age = 46.4 years, SD = 17.8 years). Each study subject was followed until a diagnosis of cancer was made (according to ICD-9-CM) or until the time the subject was censored for loss to follow-up, death, or termination of insurance-or to the end of 2009. A Cox proportional hazard regression analysis was conducted to estimate the effects of benzodiazepine use on cancer risk. In the group with benzodiazepine use, the overall risk of developing cancer was 19% higher than in the group without benzodiazepine exposure, and the difference between the groups was statistically significant (hazard ratio [HR] = 1.19; 99.6% CI, 1.08-1.32). With regard to individual types of cancer, the risk of developing liver cancer (HR = 1.45; 99.6% CI, 1.10-1.90), prostate cancer (HR = 1.72; 99.6% CI, 1.10-2.70), and bladder and kidney cancer (HR = 1.76; 99.6% CI, 1.16-2.67) was significantly higher for the benzodiazepine cohort. This population-based study has shed light on a possible relationship between benzodiazepine use and increased cancer risk. Further large, thorough investigations are needed to confirm these findings.The Journal of Clinical Psychiatry 04/2012; 73(4):e555-60. · 5.80 Impact Factor -
Article: A higher dosage of oral alendronate will increase the subsequent cancer risk of osteoporosis patients in taiwan: a population-based cohort study.
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ABSTRACT: Controversy still exists regarding whether alendronate (ALN) use increases the risk of esophageal cancer or breast cancer. This paper explores the possible association between the use of oral ALN in osteoporosis patients and subsequent cancer risk using the National Health Insurance (NHI) system database of Taiwan with a Cox proportional-hazard regression analysis. The exposure cohort contained 5,624 osteoporosis patients used ALN and randomly frequency-matched by age and gender of 3 osteoporosis patients without any kind of anti-osteoporosis drugs in the same period. For a dose ≥1.0 g/year, the risk of developing overall cancer was significantly higher (hazard ratio: 1.69, 95% confidence ratio: 1.39-2.04) than in osteoporosis patients without any anti-osteoporosis drugs. The risks for developing liver, lung, and prostate cancers and lymphoma were also significantly higher than in the control group. This population-based retrospective cohort study did not find a relationship between ALN use and either esophageal or breast cancer, but unexpectedly discovered that use of ALN with dose ≥1.0 g/year significantly increased risks of overall cancer incidence, as well as liver, lung, and prostate cancers and lymphoma. Further large population-based unbiased studies to enforce our findings are required before any confirmatory conclusion can be made.PLoS ONE 01/2012; 7(12):e53032. · 4.09 Impact Factor -
Article: A nationwide population-based cohort study: will anxiety disorders increase subsequent cancer risk?
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ABSTRACT: The aim of this study was to evaluate a possible association between malignancy and anxiety disorders (AD) in Taiwan. We employed data from the National Health Insurance system of Taiwan. The AD cohort contained 24,066 patients with each patient randomly frequency matched according to age and sex with 4 individuals from the general population without AD. Cox's proportional hazard regression analysis was conducted to estimate the influence of AD on the risk of cancer. Among patients with AD, the overall risk of developing cancer was only 1% higher than among subjects without AD, and the difference was not significant (hazard ratio [HR] = 1.01, 95% confidence interval [95% CI] = 0.95-1.07). With regard to individual types of cancer, the risk of developing prostate cancer among male patients with AD was significantly higher (HR = 1.32, 95% CI = 1.02-1.71). On the other hand, the risk of cervical cancer among female patients with AD was marginally significantly lower than among female subjects without AD (HR = 0.72, 95% CI = 0.51-1.03). One major limitation is the lack of information regarding the life style or behavior of patients in the NHI database, such as smoking and alcohol consumption. Despite the failure to identify a relationship between AD and the overall risk of cancer, we found that Taiwanese patients with AD had a higher risk of developing prostate cancer and a lower risk of developing cervical cancer.PLoS ONE 01/2012; 7(4):e36370. · 4.09 Impact Factor -
Article: Positive association between hepatitis C infection and oral cavity cancer: a nationwide population-based cohort study in taiwan.
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ABSTRACT: The association between viral hepatitis (B and C) and oral cavity cancer has been widely debated. This nationwide, population-based cohort study assessed the subsequent risk of oral cavity cancer among patients with chronic viral hepatitis infection. Data were retrieved from insurance claims data of 1,000,000 randomly sampled individuals covered under the Taiwan National Health Insurance system. We identified a total of 21,199 adults with chronic viral hepatitis infection (12,369 with HBV alone, 5,311 with HCV alone, and 3,519 with HBV/HCV dual infections) from 2000-2005. Comparison group comprised 84,796 sex- and age-matched subjects without viral hepatitis during the same study period. Incidence and risk of subsequent oral cavity cancer were measured until 2008. The incidence of oral cavity cancers was 2.28-fold higher among patients with HCV alone than non-viral hepatitis group (6.15 versus 2.69 per 10,000 person-years). After adjusting for sociodemographic covariates, HCV alone was significantly associated with an increased risk for oral cavity cancer (hazard ratio (HR) = 1.90, 95% confidence interval (CI) = 1.20-3.02). This positive association was highest among individuals in the 40-49-year age group (HR = 2.57, 95% CI = 1.21-5.46). However, there were no significant associations between HBV alone or HBV/HCV dual infections and risk for oral cavity cancer. Our data suggest that HCV but not HBV infection is a risk factor for oral cavity cancer. In addition, subjects with HCV infection tend to be at early onset risk for oral cavity cancer. This finding needs to be replicated in further studies.PLoS ONE 01/2012; 7(10):e48109. · 4.09 Impact Factor -
Article: Association between chronic viral hepatitis infection and breast cancer risk: a nationwide population-based case-control study.
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ABSTRACT: In Taiwan, there is a high incidence of breast cancer and a high prevalence of viral hepatitis. In this case-control study, we used a population-based insurance dataset to evaluate whether breast cancer in women is associated with chronic viral hepatitis infection. From the claims data, we identified 1,958 patients with newly diagnosed breast cancer during the period 2000-2008. A randomly selected, age-matched cohort of 7,832 subjects without cancer was selected for comparison. Multivariable logistic regression models were constructed to calculate odds ratios of breast cancer associated with viral hepatitis after adjustment for age, residential area, occupation, urbanization, and income. The age-specific (<50 years and ≥50 years) risk of breast cancer was also evaluated. There were no significant differences in the prevalence of hepatitis C virus (HCV) infection, hepatitis B virus (HBV), or the prevalence of combined HBC/HBV infection between breast cancer patients and control subjects (p = 0.48). Multivariable logistic regression analysis, however, revealed that age <50 years was associated with a 2-fold greater risk of developing breast cancer (OR = 2.03, 95% CI = 1.23-3.34). HCV infection, but not HBV infection, appears to be associated with early onset risk of breast cancer in areas endemic for HCV and HBV. This finding needs to be replicated in further studies.BMC Cancer 11/2011; 11:495. · 3.01 Impact Factor -
Article: The association between malignancy and end-stage renal disease in Taiwan.
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ABSTRACT: Patients with end-stage renal disease are suggestive to have a higher risk for the development of some kinds of cancer. The aim of this study is to evaluate the possible association between malignancy and end-stage renal disease in Taiwan. We used the data of the National Health Insurance system of Taiwan to assess this issue. The end-stage renal disease cohort contained 21 817 patients, and each patient was randomly frequency-matched with two people from the general population without end-stage renal disease based on their age and sex. The Cox proportional hazard regression analysis was conducted to estimate the effects of end-stage renal disease on the cancer risk. In patients with end-stage renal disease, the risk of developing overall cancer was significantly higher than the normal healthy subjects (adjusted hazard ratio = 1.64, 95% confidence interval = 1.54-1.74). This was also true when we analyzed males and females separately. For individual cancer, the risks for developing urinary tract cancers, liver cancer and breast cancer among patients with end-stage renal disease were significantly higher. On the contrary, lung, prostate and esophageal cancer risks were significantly lower when compared with the normal healthy subjects. Our study found Taiwanese patients with end-stage renal disease to have a higher risk to develop urinary tract, liver and breast cancer. We unexpectedly discovered these patients to have a lower risk to get lung, prostate and esophageal cancer.Japanese Journal of Clinical Oncology 06/2011; 41(6):752-7. · 1.78 Impact Factor -
Article: The risk of temporomandibular disorder in patients with depression: a population-based cohort study.
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ABSTRACT: This study used a population-based retrospective cohort design to examine whether depression is a risk factor of temporomandibular disorder (TMD). From a universal insurance database, we identified 7587 patients who are newly diagnosed individuals with depression in 2000 and 2001. A total of 30,197 comparison subjects were randomly selected from a nondepression cohort. Both groups were followed until the end of 2008 to measure the incidence of TMD. The incidence of TMD was 2.65 times higher in the depression cohort than in the nondepression cohort (6.16 versus 2.32 per 1000 person-years). The hazard ratio (HR) measured by multivariate Cox's proportional hazard regression analysis of TMD for the depression cohort was 2.21 (95% confidence interval (CI) 1.83-2.66), after controlling for socio-demographic factors and other psychiatric comorbidities. Women had higher risk to develop TMD than men (HR 1.61, 95% CI 1.36-1.92 for women without depression; HR 3.54, 95% CI 2.81-4.45 for women with depression). This study demonstrates that patients with depression are at an elevated risk of developing TMD.Community Dentistry And Oral Epidemiology 05/2011; 39(6):525-31. · 1.89 Impact Factor -
Article: Mental disorder as a risk factor for dog bites and post-bite cellulitis.
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ABSTRACT: Patients with mental disorders are at an increased risk for sustaining traumatic injury. No study has evaluated the association between mental disorders and the injury of dog bite. We conducted case-control studies to investigate whether people with mental disorders are at elevated risks of dog bite and post-bite cellulitis. Using insurance data of 2000-2007, we compared 4660 patients with dog bites and 18,640 controls without the events for the association with mental disorders and other covariates. Amongst those with dog bites, a nested case-control study was performed to compare 286 patients with post-bite cellulites and rest of 4374 patients for factors associated with the infection. Young children, the older adults, and people with low socioeconomic status were at an elevated risk of sustaining the dog bite. In separate logistic regression models adjusting for socio-demographic variables, the results showed that patients with concomitant psychotic and non-psychotic mental disorders were associated with increased risks of dog bites (adjusted odds ratio [OR]=1.51, 95% confidence interval [CI]: 1.32-1.74) and of post-bite cellulitis (OR=2.13, 95% CI 1.46-3.10). Individuals with mental disorders are likely at an elevated risk for serious dog bites and post-bite cellulitis.Injury 04/2011; 43(11):1903-7. · 1.98 Impact Factor -
Article: Hypertensive disorders in pregnancy and preterm delivery and subsequent stroke in Asian women: a retrospective cohort study.
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ABSTRACT: Few studies exist concerning the risk of stroke associated with hypertensive disorders in pregnancy (HDP) in Asian women. This study investigates whether preterm delivery further complicates this risk in women with HDP in Taiwan. Based on universal insurance claims data, 1092 pregnant women with newly diagnosed HDP from 2000 to 2004 and aged 15 to 40 years were identified as the HDP cohort. Then, 4715 randomly selected persons without HDP frequency matched with the index year were designated as the non-HDP controls. Both cohorts were followed-up until the end of 2008 to measure the incidence of stroke. The HDP cohort had a higher incidence of stroke than the non-HDP cohort (30.1 vs 12.8 per 10 000 person-years), with an overall adjusted hazard ratio of 2.04 (95% CI, 1.18- 3.51) for stroke. Preterm delivery increased the risk of stroke to 3.22-fold (95% CI, 1.48-6.99; P for trend=0.002). The age-specific V-shape risk association showed that the highest risk of stroke was noted among subjects 15 to 18 years old in the HDP group (hazard ratio, 13.4; 95% CI, 1.54-116.7) and followed by women aged 35 years and older (hazard ratio, 5.56; 95% CI, 1.47-21.0). Pregnant women with HDP have an increased risk of subsequent stroke. Preterm delivery and older ages increase the risk of subsequent stroke. Adolescents with HDP also have an elevated risk of stroke. Early identification of women with HDP is needed for prevention.Stroke 03/2011; 42(3):716-21. · 5.73 Impact Factor -
Article: The analysis of depression and subsequent cancer risk in Taiwan.
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ABSTRACT: Patients with depression are suggestive of having a tendency toward a marginally significant association with the subsequent cancer risk. The aim of this study was to evaluate the possible relationship between depression and cancer risk in Taiwan. We used the data of the National Health Insurance system of Taiwan to assess this issue. The Cox proportional hazard regression analysis was conducted to estimate the effects of depression on the cancer risk. In patients with depression, there was no significant change in the risk of developing overall cancer or for the site-specific cancer and all showed the same direction (positive) except for colorectal cancer, which had a negative direction. This population-based study did not find Taiwanese patients with depression to have a higher risk to develop overall cancer or site-specific cancer. Depression does not increase cancer risk.Cancer Epidemiology Biomarkers & Prevention 02/2011; 20(3):473-5. · 4.12 Impact Factor -
Article: Schizophrenia patients at higher risk of diabetes, hypertension and hyperlipidemia: a population-based study.
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ABSTRACT: This study investigates risks of developing diabetes mellitus (DM), hypertension, and hyperlipidemia in treating schizophrenia with first- and second-generation antipsychotics (FGA and SGA, respectively). We established two study sets, each consisting of patients with schizophrenia and without schizophrenia, from the insurance claims from 1997 to 2000. Study set I had 1631 patients taking FGA and 6524 non-schizophrenia controls; the other had 1224 patients taking SGA and 4896 controls. Controls were selected frequency matched with sex, age and the index year. All subjects were free of the studied metabolic disorders at the baseline. We measured incidences of these disorders developed by the end of 2008 in each cohort and their respective hazard ratios (HRs) for these disorders. Schizophrenic patients taking FGA were older than those taking SGA. In the Cox models, significance adjusted HRs associated with SGA were 1.82 (95% confidence interval (CI) 1.30-2.55) for DM and 1.41 (95% CI 1.09-1.83) for hyperlipidemia. For those on the FGA, the risk was only significant in developing DM (HR 1.32, 95% CI 1.01-1.75). The age-specific antipsychotics-associated risks for metabolic disorders were higher in young patients than in older patients particularly for hypertension; the HRs in 10-19 years of age were 4.52 (95% CI 1.76-11.6) associated with FGA and 3.92 (95% CI 1.83-8.39) associated with SGA. Patients with schizophrenia on SGA have higher risk of developing metabolic disorders than those on FGA. It is likely that older patients have already gone through the age of developing these side-effects and were free of them at the baseline.Biological Psychiatry 01/2011; 126(1-3):110-6. · 8.28 Impact Factor -
Article: Analysis of Parkinson's disease and subsequent cancer risk in Taiwan: a nationwide population-based cohort study.
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ABSTRACT: Patients with Parkinson's disease (PD) are suggested to be at a lower risk for the development of certain cancers and at a higher risk for melanoma. The aim of this study is to evaluate the possible association between PD and malignancy in Taiwan. We used the data of the National Health Insurance System of Taiwan to assess this issue. The PD cohort contained 4,957 patients, and each patient was randomly frequency matched by age and sex with 4 people from the general population without PD. Cox's proportional hazard regression analysis was conducted to estimate the effects of PD on the cancer risk. In patients with PD, the risk of developing overall cancer was marginally significantly lower than in subjects without PD [adjusted hazard ratio (HR) = 0.88; 95% CI = 0.78-0.99]. For individual cancers, the risks of developing colorectal and lung cancers among patients with PD were marginally significantly lower than in subjects without PD. In contrast, despite the higher HR for the development of melanoma, it did not reach statistical significance because of the relatively small sample size. Our study found that Taiwanese patients with PD have a lower risk of developing colorectal and lung cancers. The findings of this study are compatible with those of prior studies from other countries.Neuroepidemiology 01/2011; 37(2):114-9. · 2.31 Impact Factor
Top co-authors
Top Journals
Institutions
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2011–2013
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China Medical University Hospital
Taichung, Taiwan, Taiwan
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2011–2012
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Kaohsiung Armed Forces General Hospital
Kaohsiung, Kaohsiung, Taiwan -
Taipei Medical University
- School of Public Health
Taipei, Taipei, Taiwan
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