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Cancer Research and Treatment > Accepted Articles
doi: https://doi.org/10.4143/crt.2022.272    [Accepted]
Marked Reduction in the Risk of Dementia in Patients with Breast Cancer: A Nationwide Population-Based Cohort Study
Jooyoung Oh1,2 , Hye Sun Lee3, Soyoung Jeon3, Jeong-Ho Seok1,2, Tae-Kyung Yoo4, Woo-Chan Park4, Chang Ik Yoon4
1Department of Psychiatry, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
2Institute of Behavioral Sciences in Medicine, Yonsei University College of Medicine, Seoul, Korea
3Biostatistics Collaboration Unit, Yonsei University College of Medicine, Seoul, Korea
4Devision of Breast Surgery, Department of Surgery, Seoul St Mary’s Hospital, College of Medicine, The Catholic University of Seoul, Seoul, Korea
Correspondence  Chang Ik Yoon ,Tel: 82-2-2258-6109, Fax: 82-2-595-2822, Email: fayn03@catholic.ac.kr
Received: April 28, 2022;  Accepted: October 17, 2022.  Published online: October 19, 2022.
ABSTRACT
Purpose
An inverse relationship between cancer and neurodegenerative disease, which presents the possibility of a reduced risk of dementia in cancer patients, has been suggested previously. However, a nationwide longitudinal population-based study of specific types of cancer with due consideration of treatment effects has not been conducted.
Materials and Methods
This nationwide population-based cohort study used data obtained in a 12-year period (January 2007-December 2018) in the Korean National Health Insurance claims database. All female breast cancer patients (age≥50 years) diagnosed between 2009 and 2010 were included after excluding those with physician visits for any cancer during a 2-year period (2007-2008). Patients with senile cataract constituted the control group. The main study outcome was the risk of developing dementia.
Results
From a total of 90,396 and 85,906 patients with breast cancer and cataract, respectively, patients without behavior codes were excluded. Data for 15,407 breast cancer patients and 7,020 controls were analyzed before matching. After matching for comorbidities and age, either group comprised 2,252 patients. The median follow-up time was 104.1±24.0 months after matching. After matching, breast cancer was a predictor of a lower risk of for dementia (hazard ratio 0.091, 95% confidence intervals 0.075–0.111, p<0.0001). In breast cancer patients, receiving chemotherapy and endocrine therapy did not significantly affect the incidence of dementia.
Conclusion
Breast cancer was associated with a remarkably decreased risk of dementia. The findings strongly suggest an inverse relationship between cancer and neurodegeneration, regardless of the adverse effects of cancer treatment on cognitive function.
Key words: Breast neoplasms, Neurodegenerative diseases, Dementia, Risk, Incidence
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