Abstract
To compare the risk of cancer development between patients with glaucoma and those without, we conducted a nationwide population-based cohort study using the Korean National Health Insurance Database. Individuals with diagnosis of glaucoma between 2007 and 2016 were identified, and controls were 1:1 matched based on age and sex. We calculated the incidence rates(IR) and hazard ratios(HR) before and after adjusting for age, gender, diabetes, smoking history, and body mass index. A total of 107,536 individuals with glaucoma and the same number of individuals without glaucoma were included. The IR of overall cancer were 12.23 and 11.62 per 1,000 individuals in the glaucoma and control groups, respectively. The HR of overall cancer was significantly higher in the glaucoma group before(HR: 1.053) and after adjusting for confounding factors(adjusted HR: 1.049) compared to that in the control group. The risk of overall cancer and specific cancers varied depending on gender and age groups, and the association was stronger in women and those under 65 years of age. Our study revealed that individuals with glaucoma showed higher risk of overall cancer and higher risk of specific cancers than those without glaucoma.
Highlights
To compare the risk of cancer development between patients with glaucoma and those without, we conducted a nationwide population-based cohort study using the Korean National Health Insurance Database
In this nationwide population-based study, we compared the incidence of overall cancer and various specific cancers between 107,536 glaucoma subjects and age- and sex- matched controls
We found that individuals with glaucoma showed significantly higher risk of developing cancer overall and specific cancers including prostate and skin than those without glaucoma before and after adjusting for confounding factors
Summary
To compare the risk of cancer development between patients with glaucoma and those without, we conducted a nationwide population-based cohort study using the Korean National Health Insurance Database. Glaucoma is the leading cause of irreversible blindness worldwide, making it a major public health challenge[1,2,3] It is a neurodegenerative disease characterized by progressive retinal ganglion cell death caused by multifactorial etiology including high intraocular pressure (IOP), neurotrophin insufficiency, local ischemia-hypoxia, inflammation, glutamate excitotoxicity, oxidative stress, and aberrant immunity[4,5,6,7,8]. Among these risk factors, elevated IOP is the major risk factor[1,4], patients with normal-tension glaucoma, the most predominant form of glaucoma in Korea[9], have normal range IOP. Identifying the risk of overall cancer and specific types of cancer in glaucoma patients may improve our understanding of both diseases and provide guidelines for appropriate diagnostic work-up for cancer screening in glaucoma patients
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