目标:先前的研究报道了关于痛风与癌症风险之间关联的有争议的结果。本研究旨在探讨痛风与头颈部肿瘤发病的关系。方法:使用韩国国家健康保险数据库对2009年进行健康体检的参与者数据进行分析。总共分析了14,348名HNC患者和57,392名对照参与者的痛风病史。应用了重叠加权,分析HNC患者痛风的比值比(OR)。重叠加权模型根据人口统计进行了调整,社会经济,生活方式因素和合并症。HNC部位被归类为口腔癌,口咽癌,鼻咽癌,下咽癌,鼻腔/窦癌,喉癌,或者唾液腺癌,并估计每个部位的痛风OR。结果:总体而言,HNC患者患痛风的几率高1.12倍(95%置信区间[CIs]=1.04~1.20).根据HNC的网站,口腔癌,口咽癌,喉癌患者出现痛风的几率很高(口腔癌的OR=1.25,95%CI=1.16~1.34;口咽癌的OR=1.08,95%CI=1.01~1.15;喉癌的OR=1.12,95%CI=1.06~1.20).另一方面,鼻腔/窦癌,鼻咽癌,和唾液腺癌出现痛风的几率较低(对于鼻腔/窦癌,OR=0.78,95%CI=0.72~0.84;对于鼻咽癌,OR=0.89,95%CI=0.83~0.96;对于唾液腺癌,OR=0.88,95%CI=0.81~0.96).结论:既往痛风病史与HNC总体发病率高相关。口腔癌,口咽癌,喉癌在痛风患者中发病率较高。然而,鼻腔/窦癌,鼻咽癌,而涎腺癌在痛风患者中发病率较低。痛风对HNC风险的影响应根据HNC的部位具体考虑。
Objective: Previous studies have reported controversial results on the association between gout and the risk of cancer. This study aimed to investigate the relationship between gout and the incidence of head and neck cancer (HNC). Methods: The data of participants who underwent health checkups in 2009 were analyzed using the National Health Insurance Database in South Korea. A total of 14,348 HNC patients and 57,392 control participants were analyzed for a prior history of gout. Overlap weighting was applied, and odds ratios (ORs) of gout for HNC patients were analyzed. The overlap-weighted model adjusted for demographic, socioeconomic, and lifestyle factors and comorbidities. HNC sites were classified as oral cavity cancer, oropharyngeal cancer, nasopharyngeal cancer, hypopharyngeal cancer, nasal cavity/sinus cancer, larynx cancer, or salivary gland cancer, and the ORs of gout were estimated for each site. Results: Overall, patients with HNC had 1.12-fold greater odds of having gout (95% confidence intervals [CIs] = 1.04-1.20). According to the site of HNC, oral cavity cancer, oropharynx cancer, and larynx cancer demonstrated high odds of having gout (OR = 1.25, 95% CI = 1.16-1.34 for oral cavity cancer; OR = 1.08, 95% CI = 1.01-1.15 for oropharynx cancer; and OR = 1.12, 95% CI = 1.06-1.20 for larynx cancer). On the other hand, nasal cavity/sinus cancer, nasopharynx cancer, and salivary gland cancer presented low odds of having gout (OR = 0.78, 95% CI = 0.72-0.84 for nasal cavity/sinus cancer; OR = 0.89, 95% CI = 0.83-0.96 for nasopharynx cancer; and OR = 0.88, 95% CI = 0.81-0.96 for salivary gland cancer). Conclusions: A prior history of gout was associated with a high overall incidence of HNC. Oral cavity cancer, oropharynx cancer, and larynx cancer have a high incidence in gout patients. However, nasal cavity/sinus cancer, nasopharyngeal cancer, and salivary gland cancer have low incidences in gout patients. The impact of gout on HNC risk should be specifically considered according to the site of the HNC.