Cancer risk in a cohort of polio patients

Nielsen, Nete Munk; Wohlfahrt, Jan; Aaby, Péter; Hjalgrim, Henrik; Pedersen, Carsten Bøcker; Askgaard, Dorthe; Melbye, Mads

doi:10.1002/ijc.1218

Cited by 13 publications

(11 citation statements)

References 26 publications

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“…Specifically, we found increased risk of respiratory diseases, gastrointestinal diseases, cardiovascular diseases, Parkinson's disease, cancer and psychiatric diseases, which are all consistent with previous observations from Western populations [12,13,15,17,23]. One advantage of our study is the use of a nationwide database with a large representative sample that provides sufficient statistical power to detect subtle differences.…”

Section: Discussionsupporting

confidence: 90%

“…Previous reports of comorbid conditions in poliomyelitis survivors mainly focused on some disease categories, such as respiratory diseases, gastrointestinal diseases, psychiatric diseases, neurological diseases and cancer [11][12][13][14][15]. Data regarding a wide spectrum of medical comorbidities in patients with poliomyelitis is still sparse [16][17][18].…”

Section: Introductionmentioning

confidence: 99%

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Comorbidity profile of poliomyelitis survivors in a Chinese population: a population-based study

Kang¹,

Lin²

2011

J Neurol

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Previous reports of comorbid conditions in poliomyelitis survivors mainly focused on some disease categories, such as respiratory diseases, gastrointestinal diseases, psychiatric diseases, neurological diseases and cancer. Data regarding a wide spectrum of medical comorbidities in patients with poliomyelitis is still sparse. This study aimed to investigate and profile the wide range of comorbidities among the survivors of paralytic poliomyelitis in a Chinese population. In total, 2,032 paralytic poliomyelitis patients were selected as the study group and the comparison group consisted of 10,160 randomly selected enrollees. The comorbidities for analysis were based on a modified version of the Elixhauser Comorbidity Index. Conditional logistic regression analyses were computed to investigate the risk of comorbidities for these two groups. As compared to controls, patients with paralytic poliomyelitis had significantly higher prevalence of hypertension, ischemic heart disease, hyperlipidemia, congestive heart failure, cardiac arrhythmias, peripheral vascular disorder, stroke, paralysis, migraines, Parkinson's disease, rheumatoid arthritis, ankylosing spondylitis, pulmonary circulation disorders, chronic pulmonary disease, liver disease, peptic ulcers, hepatitis B or C, deficiency anemias, depression, and lymphoma. Most of the differences are of clinical interest, ORs often being between 2 and 3. No significant difference between poliomyelitis patients and controls was observed in the prevalence of SLE, tuberculosis, alcohol abuse and drug abuse. Our findings demonstrate that survivors of paralytic poliomyelitis in Taiwan are at higher risk of having multiple medical comorbidities although some potential confounding factors including educational level, marital status, obesity and physical activity are not available in our database. The pattern is generally consistent with previous observations from Western populations. Nevertheless, we found several novel associations which have rarely, if ever, been reported previously.

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Section: Discussionsupporting

confidence: 90%

Section: Introductionmentioning

confidence: 99%

Comorbidity profile of poliomyelitis survivors in a Chinese population: a population-based study

Kang¹,

Lin²

2011

J Neurol

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“…These include enteroviruses, which infect via the gastrointestinal tract and can have neurological consequences. In post-poliomyelitis syndrome, there is systemic illness with raised serum inflammatory markers, and metabolic and skin involvement [43-45]. Parkinsonism is reported [46], lymphopenia not.…”

Section: Discussionmentioning

confidence: 99%

Blood profile holds clues to role of infection in a premonitory state for idiopathic parkinsonism and of gastrointestinal infection in established disease

Charlett

Dobbs

et al. 2009

Gut Pathog

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The two-stage neuroinflammatory process, containment and progression, proposed to underlie neurodegeneration may predicate on systemic inflammation arising from the gastrointestinal tract. Helicobacter infection has been described as one switch in the pathogenic-circuitry of idiopathic parkinsonism (IP): eradication modifies disease progression and marked deterioration accompanies eradication-failure. Moreover, serum Helicobacter-antibody-profile predicts presence, severity and progression of IP. Slow gastrointestinal-transit precedes IP-diagnosis and becomes increasingly-apparent after, predisposing to small-intestinal bacterial-overgrowth (SIBO). Although IP is well-described as a systemic illness with a long prodrome, there has been no comprehensive overview of the blood profile. Here, it is examined in relation to Helicobacter status and lactulose-hydrogen-breath-testing for SIBO.A robust finding of reduced lymphocyte count in 126 IP-probands and 79 spouses (without clinically-definite IP), compared with that in 381 controls (p < 0.001 in each case), was not explained by Helicobacter-status or breath-hydrogen. This complements a previous report that spouses were 'down-the-pathway' to 'clinically-definite' disease. In 205 other controls without clinically-definite IP, there were strong associations between sporadic cardinal features and immunoglobulin class concentration, not explained by Helicobacter-status. Premonitory states for idiopathic parkinsonism associated with relative lymphopenia, higher serum immunoglobulin concentrations and evidence of enteric-nervous-system damage may prove viral in origin.Although only 8% of the above 79 spouses were urea-breath-test-positive for Helicobacter, all 8 spouses with clinically-definite IP were (p < 0.0001). Transmission of a 'primer' to a Helicobacter-colonised recipient might result in progression to the diagnostic threshold.Twenty-five percent of the 126 probands were seropositive for anti-nuclear autoantibody. In 20 probands, monitored before and serially after anti-Helicobacter therapy, seropositivity marked a severe hypokinetic response (p = 0.03). It may alert to continuing infection, even at low-density. Hyperhomocysteinemia is a risk factor for dementia and depression. Serum homocysteine exceeded the target in 43% of the 126 IP-probands. It was partially explained by serum B12 (12% variance, p < 0.001), but not by Helicobacter-status (gastric-atrophy uncommon in IP) or levodopa treatment. Immune-inflammatory activation increases homocysteine production. Since an estimated 60% of probands are hydrogen-breath-test positive, SIBO, with its increased bacterial utilisation of B12, is a likely cause. Thus, two prognostic indicators in established IP fit with involvement of Helicobacter and SIBO.

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“…1 We present a case of skin cancers arising in a patient with polio to further strengthen this possible association. In addition to morbidity secondary to paralytic polio and postpolio syndrome, an association with malignant neoplasm has been proposed.…”

Section: Skin Cancer Presenting As a Nonhealing Wound: The Associatiomentioning

confidence: 71%

“…1 There was a 66% increased risk of skin cancer, primarily nonmelanoma. 1 There was a 66% increased risk of skin cancer, primarily nonmelanoma.…”

Section: Commentmentioning

confidence: 99%

Skin Cancer Presenting as a Nonhealing Wound: The Association of Polio and Skin Cancer

Vu¹,

Bangert²,

Hebert

2007

Arch Dermatol

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Cancer risk in a cohort of polio patients

Cited by 13 publications

References 26 publications

Comorbidity profile of poliomyelitis survivors in a Chinese population: a population-based study

Comorbidity profile of poliomyelitis survivors in a Chinese population: a population-based study

Blood profile holds clues to role of infection in a premonitory state for idiopathic parkinsonism and of gastrointestinal infection in established disease

Skin Cancer Presenting as a Nonhealing Wound: The Association of Polio and Skin Cancer

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