■肠道微生物组可能在结肠癌的病因和进展中起重要作用。本假设检验研究比较了诊断为肠道梭状芽孢杆菌(以前为艰难梭状芽孢杆菌)(Cdiff队列)的成年人与未诊断为肠道Cdiff感染的成年人(非Cdiff队列)的结肠癌发病率。
■检查了1990年至2012年在佛罗里达医疗补助系统中注册的纵向成人队列(整体队列)中的独立医疗保健研究数据库(IHRD)中的取消识别资格和索赔记录。对连续8年以上门诊就诊的成年人进行了检查。Cdiff队列中有964名成年人,非Cdiff队列中有292,136名成年人。使用频率和Cox比例风险模型。
■在整个研究期间,非Cdiff队列中的结肠癌发病率保持相对一致,而在Cdiff诊断的前4年内,Cdiff队列中观察到显著增加。与非Cdiff队列(每1000人年1.16)相比,Cdiff队列(每1000人年3.11)的结肠癌发病率显着增加(约2.7倍)。性别调整,年龄,residence,出生日期,结肠镜检查筛查,癌症家族史,以及个人的烟草滥用史,酗酒/依赖,药物滥用/依赖,超重/肥胖,以及考虑溃疡性结肠炎和感染性结肠炎的诊断状态,免疫缺陷,和个人癌症史没有显著改变观察到的结果。
■这是第一个将Cdiff与结肠癌风险增加相关的流行病学研究。未来的研究应该进一步评估这种关系。
UNASSIGNED: The gut microbiome may play an important role in the etiology and progression of colon cancer. The present hypothesis-testing study compared the colon cancer incidence rate among adults diagnosed with intestinal Clostridioides (formerly Clostridium) difficile (Cdiff) (the Cdiff cohort) to adults not diagnosed with intestinal Cdiff infection (the non-Cdiff cohort).
UNASSIGNED: De-identified eligibility and claim healthcare records within the Independent Healthcare Research Database (IHRD) from a longitudinal cohort of adults (the overall cohort) enrolled in the Florida Medicaid system between 1990 through 2012 were examined. Adults with ≥ 8 outpatient office visits over 8 years of continuous eligibility were examined. There were 964 adults in the Cdiff cohort and 292,136 adults in the non-Cdiff cohort. Frequency and Cox proportional hazards models were utilized.
UNASSIGNED: Colon cancer incidence rate in the non-Cdiff cohort remained relatively uniform over the entire study period, whereas a marked increase was observed in the Cdiff cohort within the first 4 years of a Cdiff diagnosis. Colon cancer incidence was significantly increased (about 2.7-fold) in the Cdiff cohort (3.11 per 1,000 person-years) compared to the non-Cdiff cohort (1.16 per 1,000 person-years). Adjustments for gender, age, residency, birthdate, colonoscopy screening, family history of cancer, and personal history of tobacco abuse, alcohol abuse/dependence, drug abuse/dependence, and overweight/obesity, as well as consideration of diagnostic status for ulcerative and infection colitis, immunodeficiency, and personal history of cancer did not significantly change the observed results.
UNASSIGNED: This is the first epidemiological study associating Cdiff with an increased risk for colon cancer. Future studies should further evaluate this relationship.