Abstract
Background: Colorectal cancer (CRC) is the third leading cause of cancer-related deaths in Taiwan. Chronic obstructive pulmonary disease (COPD) is associated with CRC mortality in several population-based studies. However, this effect of COPD on CRC shows no difference in some studies and remains unclear in Taiwan’s population. Methods: We conducted a retrospective cohort study using Taiwan’s nationwide database. Patients newly diagnosed with CRC were identified from 2007 to 2012 via the Taiwan Cancer Registry dataset and linked to the National Health Insurance research database to obtain their medical records. Propensity score matching (PSM) was applied at a ratio of 1:2 in COPD and non-COPD patients with CRC. The 5-year overall survival (OS) was analyzed using the Cox regression method. Results: This study included 43,249 patients with CRC, reduced to 13,707 patients after PSM. OS was lower in the COPD group than in the non-COPD group. The adjusted hazard ratio (aHR) for COPD was 1.26 (95% confidence interval (CI), 1.19–1.33). Moreover, patients with CRC plus preexisting COPD showed a higher mortality risk in all stage CRC subgroup analysis. Conclusions: In this 5-year retrospective cohort study, patients with CRC and preexisting COPD had a higher mortality risk than those without preexisting COPD, suggesting these patients need more attention during treatment and follow-up.
Highlights
Colorectal cancer (CRC) is a common and fatal malignancy, estimated to reach 2.5 million cases worldwide by 2035 [1]
Between 2007 and 2012, 43,249 patients newly diagnosed with CRC were included in this study
According to the Chronic obstructive pulmonary disease (COPD) records, patients were classified into two groups—before or after CRC was diagnosed
Summary
Colorectal cancer (CRC) is a common and fatal malignancy, estimated to reach 2.5 million cases worldwide by 2035 [1]. 16,525 cases in 2018, as analyzed by the Taiwan Cancer Registry (TwCR)) [2]. Asymptomatic patients with CRC diagnosed by screening have a better risk against death, recurrence, survival, and disease-free interval than those not diagnosed by screening [6]. Chronic obstructive pulmonary disease (COPD) is associated with CRC mortality in several population-based studies. This effect of COPD on CRC shows no difference in some studies and remains unclear in Taiwan’s population. Patients newly diagnosed with CRC were identified from 2007 to 2012 via the Taiwan Cancer Registry dataset and linked to the National Health Insurance research database to obtain their medical records. Propensity score matching (PSM) was applied at a ratio of 1:2 in COPD and non-COPD patients with CRC. The adjusted hazard ratio (aHR) for COPD was 1.26 (95% confidence interval (CI), 1.19–1.33)
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