Acute Pericarditis and Cancer Risk: A Matched Cohort Study Using Linked UK Primary and Secondary Care Data
Background We aimed to examine whether acute pericarditis is an indicator of undetected cancer and identify patient‐level factors associated with high cancer risk among patients presenting with pericarditis. Methods and Results A population‐based matched cohort study was conducted using primary care...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2018-08-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| Subjects: | |
| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.118.009428 |
| _version_ | 1811328981181399040 |
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| author | Kirstine Kobberøe Søgaard Henrik Toft Sørensen Liam Smeeth Krishnan Bhaskaran |
| author_facet | Kirstine Kobberøe Søgaard Henrik Toft Sørensen Liam Smeeth Krishnan Bhaskaran |
| author_sort | Kirstine Kobberøe Søgaard |
| collection | DOAJ |
| description | Background We aimed to examine whether acute pericarditis is an indicator of undetected cancer and identify patient‐level factors associated with high cancer risk among patients presenting with pericarditis. Methods and Results A population‐based matched cohort study was conducted using primary care data from the UK Clinical Practice Research Datalink linked to Hospital Episode Statistics. Patients with acute pericarditis (n=6530) were matched to a comparison cohort (n=26 111) on age, sex, calendar time, and general practice. We estimated cumulative cancer incidences, and calculated hazard ratios using Cox regression. Effect modification by patients' characteristics and lifestyle factors was examined, and we fitted a parsimonious model to evaluate absolute excess risk of later cancer among pericarditis patients by key patient‐level factors. We identified 728 and 1379 incidents of cancer among pericarditis patients and the comparison cohort (median follow‐up, 2.8 and 3.5 years). Pericarditis was associated with an elevated subsequent risk of any cancer (hazard ratio=3.03; 95% confidence interval, 2.74–3.36). The association was particularly pronounced 0 to 3 months after pericarditis (hazard ratio=23.56; 95% confidence interval, 18.00–30.83), but a more‐modest association remained thereafter (hazard ratio=1.95; 95% confidence interval, 1.48–2.57 after 3–12 months, and hazard ratio=1.40; 95% confidence interval, 1.21–1.62 after >12 month). Older individuals hospitalized with pericarditis and with combinations of obesity and smoking were at the highest excess risk of having a cancer diagnosis 3 to 12 months later, reaching 4.8%. Conclusions Occult cancers may be going undiagnosed during the acute episode of pericarditis. Patients presenting with pericarditis and combinations of older age, obesity, smoking, and a need for hospitalization might warrant targeted investigations for cancer. |
| first_indexed | 2024-04-13T15:35:43Z |
| format | Article |
| id | doaj.art-b14f19f8d8b241e0a5ee6d470fdb5d38 |
| institution | Directory Open Access Journal |
| issn | 2047-9980 |
| language | English |
| last_indexed | 2024-04-13T15:35:43Z |
| publishDate | 2018-08-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj.art-b14f19f8d8b241e0a5ee6d470fdb5d382022-12-22T02:41:17ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802018-08-0171610.1161/JAHA.118.009428Acute Pericarditis and Cancer Risk: A Matched Cohort Study Using Linked UK Primary and Secondary Care DataKirstine Kobberøe Søgaard0Henrik Toft Sørensen1Liam Smeeth2Krishnan Bhaskaran3Non‐Communicable Diseases Epidemiology London School of Hygiene and Tropical Medicine London United KingdomDepartment of Clinical Epidemiology Institute of Clinical Medicine Aarhus University Hospital Aarhus N DenmarkNon‐Communicable Diseases Epidemiology London School of Hygiene and Tropical Medicine London United KingdomNon‐Communicable Diseases Epidemiology London School of Hygiene and Tropical Medicine London United KingdomBackground We aimed to examine whether acute pericarditis is an indicator of undetected cancer and identify patient‐level factors associated with high cancer risk among patients presenting with pericarditis. Methods and Results A population‐based matched cohort study was conducted using primary care data from the UK Clinical Practice Research Datalink linked to Hospital Episode Statistics. Patients with acute pericarditis (n=6530) were matched to a comparison cohort (n=26 111) on age, sex, calendar time, and general practice. We estimated cumulative cancer incidences, and calculated hazard ratios using Cox regression. Effect modification by patients' characteristics and lifestyle factors was examined, and we fitted a parsimonious model to evaluate absolute excess risk of later cancer among pericarditis patients by key patient‐level factors. We identified 728 and 1379 incidents of cancer among pericarditis patients and the comparison cohort (median follow‐up, 2.8 and 3.5 years). Pericarditis was associated with an elevated subsequent risk of any cancer (hazard ratio=3.03; 95% confidence interval, 2.74–3.36). The association was particularly pronounced 0 to 3 months after pericarditis (hazard ratio=23.56; 95% confidence interval, 18.00–30.83), but a more‐modest association remained thereafter (hazard ratio=1.95; 95% confidence interval, 1.48–2.57 after 3–12 months, and hazard ratio=1.40; 95% confidence interval, 1.21–1.62 after >12 month). Older individuals hospitalized with pericarditis and with combinations of obesity and smoking were at the highest excess risk of having a cancer diagnosis 3 to 12 months later, reaching 4.8%. Conclusions Occult cancers may be going undiagnosed during the acute episode of pericarditis. Patients presenting with pericarditis and combinations of older age, obesity, smoking, and a need for hospitalization might warrant targeted investigations for cancer.https://www.ahajournals.org/doi/10.1161/JAHA.118.009428alcohollifestyleneoplasiaobesitysmoking |
| spellingShingle | Kirstine Kobberøe Søgaard Henrik Toft Sørensen Liam Smeeth Krishnan Bhaskaran Acute Pericarditis and Cancer Risk: A Matched Cohort Study Using Linked UK Primary and Secondary Care Data Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease alcohol lifestyle neoplasia obesity smoking |
| title | Acute Pericarditis and Cancer Risk: A Matched Cohort Study Using Linked UK Primary and Secondary Care Data |
| title_full | Acute Pericarditis and Cancer Risk: A Matched Cohort Study Using Linked UK Primary and Secondary Care Data |
| title_fullStr | Acute Pericarditis and Cancer Risk: A Matched Cohort Study Using Linked UK Primary and Secondary Care Data |
| title_full_unstemmed | Acute Pericarditis and Cancer Risk: A Matched Cohort Study Using Linked UK Primary and Secondary Care Data |
| title_short | Acute Pericarditis and Cancer Risk: A Matched Cohort Study Using Linked UK Primary and Secondary Care Data |
| title_sort | acute pericarditis and cancer risk a matched cohort study using linked uk primary and secondary care data |
| topic | alcohol lifestyle neoplasia obesity smoking |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.118.009428 |
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