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Population-Based Cohort Study Reveals Distinct Associations Between Female Lung Cancer and Breast Cancer in Taiwan
Emily Pei-Ying Lin1, Ching-Heng Lin1, Ching-Yao Yang1
1Emily Pei-Ying Lin and Ching-Yao Yang, National Taiwan University Hospital; Chong-Jen Yu, K. Arnold Chan, and Pan-Chyr Yang, National Taiwan University Hospital and College of Medicine; Tzu-Pin Lu, National Taiwan University; Bo-Tsang Huang and Pan-Chyr Yang, Institute of Biomedical Sciences, Academia Sinica, Taipei, Taiwan; Ching-Heng Lin, Shih-Ni Chang, and Tzu-Hung Hsiao, Taichung Veterans General Hospital; and Shih-Ni Chang, China Medical University Hospital, Taichung, Taiwan.
Purpose:
Associations between Asian lung cancer (LC) and breast cancer (BC) are unknown. This study evaluates associations between LC and BC in the Taiwan population.
Methods:
This study was based on the Taiwan National Health Insurance data and Taiwan Cancer Registry. The cohorts included women with newly diagnosed LC or BC between 2000 and 2011 and an age- and sex-stratified random sample as a noncancer comparison cohort during the same period. Cox proportional hazards regression analysis was used to determine the risks. The National Taiwan University Hospital (NTUH) cohort, which comprised patients with confirmed pathology diagnoses of double BC/LC, was reviewed.
Results:
In 32,824 women with LC, there were increased risks for synchronous BC in patients younger than age 50 years (hazard ratio, 5.80; 95% CI, 1.83 to 18.73), age 50 to 59 years (HR, 2.37; 95% CI, 1.02 to 5.54), and age 60 to 69 years (HR, 4.42; 95% CI, 1.91 to 10.2). In the 88,446 women with BC, there were increased risks for synchronous LC in patients age 40 to 59 years (HR, 5.86; 95% CI, 3.05 to 11.3) and older than 60 years (HR, 1.98; 95% CI, 1.04 to 3.77). In the 128-patient NTUH double LC/BC cohort, 77 (60%) had both cancers diagnosed within 5 years of each other.
Conclusion:
LC is associated with an increased risk for synchronous BC in Taiwan and vice versa. Radiotherapy might not be a major risk factor for LC in BC survivors. Etiology for double LC/BC deserves additional exploration and cross-racial genomic studies.
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