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P1.05 Higher risk of prostate cancer and thyroid cancer in doctors in Taiwan Yueh-Han Hsu1,2, MD, MPH, PhD; Wen-Chen Tsai2, DrPH; Wei Chen1, MD 1 Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chia-Yi City, Taiwan 2 Department of Health Services Administration, China Medical University, Taichung City, Taiwan Abstract Introduction The health of physicians may influence the quality of the national health care; only physicians with sound health may deliver high quality health services. With profound medical knowledge and healthcare network, doctors were expected to have lower risk of cancer. However, doctors have heavy work-loads since their student ear, they might not necessarily conduct healthy life pattern. Previous research were inconsistent with regards to area and study design. Purpose and Methods We investigated the risk of 15 major cancers of the doctors in Taiwan from a nation-wide health claims database 2000~2012 and Taiwan Cancer Registry File. We included all doctors aged over 25 who practiced medicine in 2000. The control group included all non-health care people with same age limit in 2000. The exclusion criteria were previous history of cancers, AIDS and organ transplant. We conducted propensity score matches of 1:1 ratio with gender, age, residence urbanization and severity of comorbidity by Charles Comorbidity Index (CCI). We used Cox proportional hazard to evaluate the risks of cancers among these groups. Results In all, the case numbers in both groups were 29713. Till the end of follow-ups, there were 1326 and 1533 incident cases of cancers in the doctors and non-doctors groups. The distribution of cancers in both groups were different. In the doctor group, the most prevalent 5 cansers were breast cancer, colorectal cancer, prostate cancer, hepatoma and lung cancer; for non-doctor group, they were breast cancer, hepatoma, colorectoal cancer, lung caner and orapharyngeal cancer. The cancer distributions in both genders of doctors were also different. Under Cox model, doctors had 10% lower overall cancer risk (4.46% vs 5.16%, p<0.001). Among doctors, male had lower cancer risk (adjusted HR (aHR) 0.63, 95% confidence interval (CI) 0.51-0.78, p <0.001). Comparing the cancer risks in 15 major cancers between doctors and non-doctors, doctors had higher risks of prostate cancer (aHR 1.26, 95%CI 1-1.59, p=0.046) and thyroid cancer (aHR 3.16, 95%CI 1.69-5.90, p<0.001). Table. 11 Characteristics Characteristics of of participants participants after after 1:1 1:1 propensity propensity Table. score matching matching score Table. 2 Risk factors of cancer in doctors under Cox proportional model Variable After matching (1:1) Variable Total Total Non-doctors Doctors N % N % N 59426 100.00 29713 50.00 29713 % Male Adjusted HR 1.33 0.005 0.63 0.51 0.78 <0.001 95% CI P value Female (ref) Male 1.000 Female P value Sex P value 50.00 Sex Unadjusted HR CCI score 6406 10.78 3203 10.78 3203 10.78 0 (ref) 53020 89.22 26510 89.22 26510 89.22 1~3 8.31 <0.001 8.08 4.42 14.77 <0.001 4~6 19.76 <0.001 14.79 8.11 26.96 <0.001 Age 1.000 ≦34 15544 26.16 7772 26.16 7772 26.16 7~9 42.68 <0.001 23.45 12.84 42.82 <0.001 35-44 20220 34.03 10110 34.03 10110 34.03 ≧10 63.41 <0.001 26.67 14.56 48.86 <0.001 45-54 11630 19.57 5815 19.57 5815 19.57 55-64 4266 7.18 2133 7.18 2133 7.18 65-74 4170 7.02 2085 7.02 2085 7.02 ≧75 3596 6.05 1798 6.05 1798 6.05 45.20 14.51 45.14 14.63 45.25 14.39 Average age (Mean, Std) Level of residence urbanization Level 1 (ref) Also adjusted for age and level of residence of urbanization Table. 3 The adjusted risk of cancers in doctors and non-doctors under Cox proportional model 1.000 23872 40.17 11936 40.17 11936 Non-doctors 40.17 Level 2 and 3 27156 45.7 13578 45.7 13578 45.7 Level 4 and 5 6374 10.73 3187 10.73 3187 10.73 Level 6 and 7 2024 3.41 1012 3.41 1012 3.41 CCI score Cancers of primary anatomic sites 1.000 Adjusted HRd Doctors No Incidencea No Breast cancer c 30 85.47 Colon, rectum, rectosigmoid junction and anus cancer 227 Prostate gland cancer b Incidence a HR 95%CI P value 47 134.20 1.58 1.00 2.49 0.052 69.67 235 72.10 1.03 0.86 1.24 0.742 130 44.65 165 56.71 1.26 1.00 1.59 0.046 0 20530 34.55 10265 34.55 10265 34.55 Liver and intrahepatic bile ducts cancer 232 71.21 158 48.44 0.68 0.56 0.83 <0.001 1~3 21984 36.99 10992 36.99 10992 36.99 Trachea, bronchus and lung cancer 209 64.12 146 44.75 0.69 0.56 0.86 <0.001 4~6 10988 18.49 5494 18.49 5494 18.49 Ovary, fallopian tube and broad ligament cancer c 0 0.00 11 31.24 -- -- -- -- 7~9 4182 7.04 2091 7.04 2091 7.04 Stomach cancer 76 23.27 81 24.80 1.06 0.78 1.45 0.716 ≧10 1742 2.93 871 2.93 871 2.93 Corpus uteri cancer c 2 5.68 6 17.04 3.00 0.61 14.85 0.179 Bladder cancer 67 20.51 43 13.16 0.64 0.44 0.94 0.022 Thyroid gland cancer 13 3.98 41 12.54 3.16 1.69 5.90 <0.001 Nasopharynx cancer 45 13.77 29 8.87 0.65 0.41 1.03 0.066 Cervix uteri cancer c 3 8.51 3 8.51 1.00 0.20 4.94 0.997 Oral cavity, oropharynx and hypopharynx cancer 147 45.05 25 7.65 0.17 0.11 0.26 <0.001 Esophagus cancer 61 18.67 16 4.89 0.26 0.15 0.45 <0.001 Skin cancer 20 6.12 13 3.98 0.65 0.32 1.31 0.226 Other cancer 283 86.92 317 97.43 1.12 0.95 1.31 0.170 Conclusions a Incidence: Doctors have higher risk of prostate cancer and thyroid cancer in Taiwan per 100,000 person-years. b Incidence of per 100,000 person-years for men. person-years for women. d adjusted for age, sex c Incidence of per 100,000