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    Please use this identifier to cite or link to this item: http://ir.cnu.edu.tw/handle/310902800/31087

    標題: Death Does Matter-Cancer Risk in Patients With End-Stage Renal Disease A Nationwide Population-Based Study With Competing Risk Analyses
    作者: Weng, Shih-Feng
    Chiu, Yu-Hsien
    Jan, Ren-Long
    Chen, Yi-Chen
    Chien, Chih-Chiang
    Wang, Jhi-Joung
    Chu, Chin-Chen
    貢獻者: Kaohsiung Med Univ, Dept Healthcare Adm & Med Informat
    Chi Mei Med Ctr, Dept Pediat
    Natl Cheng Kung Univ, Grad Inst Clin Med
    Chi Mei Med Ctr, Dept Med Res
    Chi Mei Med Ctr, Dept Nephrol
    Chung Hwa Univ Med Technol, Dept Food Nutr
    Chi Mei Med Ctr, Dept Anesthesiol
    Chia Nan Univ Pharm & Sci, Dept Recreat & Hlth Care Management
    關鍵字: chronic dialysis patients
    日期: 2016-01
    上傳時間: 2018-01-18 11:41:31 (UTC+8)
    出版者: Lippincott Williams & Wilkins
    摘要: Patients with end-stage renal disease (ESRD) have a high mortality rate. We hypothesized that not accounting for death as a competing risk overestimates the event rate caused by ESRD. Thus, we examined the cancer risk for patients with ESRD (ESRDPos) after death as a competing risk event had been adjusted for. Patients with newly diagnosed ESRD (n = 64,299) between 1999 and 2007, together with age- and sex-matched controls without ESRD (ESRDNeg) (n = 128,592) were enrolled (1:2). In a Cox proportional hazards model that included death as a competing risk, ESRDPos patients in Taiwan had a lower overall incidence (subdistribution hazard ratio [sdHR] = 1.29) of cancer than did ESRDNeg patients in a Cox model that did not include death as a competing risk (HR = 1.70). After competing mortality had been adjusted for, ESRDPos patients >= 70 (sdHR = 0.82) and ESRDPos patients on long-term dialysis (> 5 follow-up years, sdHR = 0.62), had a lower risk for developing cancer than did ESRDNeg patients. This finding supported our hypothesis that standard survival analyses overestimate the event rate, especially when the mortality rate is high. It also showed that ESRDPos patients, when they grow older, were far less likely to develop cancer and far more likely to die because of underlying illnesses that might also affect the risk of death because of ESRD.
    關聯: Medicine, v.95 n.3, e2512
    Appears in Collections:[休閒保健管理系(所)] 期刊論文

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