Journal Name and Year Published
Cancer risk associated with chronic diseases and disease markers: Prospective cohort study, published in 2018.
General Epidemiology of the Issue
Chronic illnesses are a major contributor to the world’s annual mortality rate. For instance, they were responsible for 71% of the global deaths in 2015 caused by chronic kidney disease, diabetes, cardiovascular disease, and respiratory illnesses (Tu et al., 2018). Cancer-related deaths increased from approximately 5.7 million in 1990 to 8.8 million in 2015 (Tu et al., 2018). The global burden of cancer is expected to rise in the coming years.
The Study Purpose
The study was designed to evaluate the joint and independent associations of specific chronic illnesses and disease markers with cancer risk. In addition, the researchers intended to assess the benefit of physical activity with regard to the risk of developing cancer associated with chronic illnesses and disease markers.
The Study Hypothesis(es)
The researchers hypothesized that there was a link between chronic illnesses and the risk of developing cancer. The study participants engaged in a fee-for-service medical screening program in Taiwan. The areas represented included Taipei, Taoyuan, Taichung, and Kaohsiung and most of the participants were adults aged below forty years (Tu et al., 2018). The exclusion criteria included individuals less than 18 years of age, with less than a year of follow-up, and a history of cancer during recruitment (Tu et al., 2018). The final study population consisted of 405878 individuals, of whom 52% were women and 48% were men (Tu et al., 2018). They were all encouraged to return for a second visit during the study period.
The Study Design
The study design involved the classification of the volume of leisure-time physical activity and the duration of exercise into five categories. In addition, five common chronic diseases were selected for evaluation, and information on cancer incidence was gathered by linking the study participants to Taiwan’s cancer registry using unique identification numbers.
The Statistical Techniques Used in the Study
The Cox proportional hazards model was used as a statistical method to estimate hazard ratios. In addition, the researchers used it to calculate 95% confidence intervals while adjusting for age, education, sex, occupation, body mass index, smoking status, and alcohol consumption (Tu et al., 2018). They also used the Markov Chain Monte Carlo procedures to perform multiple imputations.
The Main Findings
The study results demonstrated a significantly increased risk of incident cancer in eight chronic diseases. In addition, all eight disease markers were linked to an increased risk of cancer death. The researchers used cancer incidence rates as a measure of their findings. The findings are plausible in view of the fact that previous studies have demonstrated a link between chronic illnesses and cancer prevalence.
The Bias or Error in the Study
There were no areas of bias or error noted.
The Strengths and Weaknesses of the Study
The study’s strengths included the fact that it evaluated multiple illnesses and markers simultaneously. In addition, the illnesses were diagnosed using quantitative medical examinations. The study had a few weaknesses, such as its use of observational techniques, which means that some of the associations were not causal. The data has limited generalizability, given that the findings are dependent on disease prevalence in a specific area. I liked the study’s reliance on Taiwan’s centralized cancer registry. I would include more illnesses in the study to make the data representative of the general population.
The Conclusion of the Study
The researchers concluded that chronic diseases are an important risk factor for the development of cancer. They also noted that physical activity contributes immensely to the reduction of cancer risk associated with chronic diseases.
Tu, H., Wen, C. P., Tsai, S. P., Chow, W. H., Wen, C., Ye, Y., Zhao, H., Tsai, M. K., Huang, M., Dinney, C. P., Tsao, C. K., & Wu, X. (2018). Cancer risk associated with chronic diseases and disease markers: Prospective cohort study. BMJ (Clinical Research Ed.), 360(134), 1–12. Web.