Gram-negative bacteremia as a clinical marker of occult malignancy - 18/04/17
, Dóra K. Farkas a, Mette Søgaard a, Henrik C. Schønheyder b, c, Reimar W. Thomsen a, Henrik T. Sørensen aSummary |
Objectives |
Gram-negative bacteremia may be a harbinger of occult cancer. We examined the risk of cancer following hospitalization with bacteremia.
Methods |
Using medical databases, we conducted a nationwide population-based cohort study of all Danes with a discharge diagnosis of Gram-negative bacteremia during 1994–2013. We calculated absolute risks and standardized incidence ratios (SIRs) of cancer, comparing the observed risk to that expected in the general population.
Results |
We observed 1379 cancers vs. 988 expected among 11,753 patients with Gram-negative bacteremia, corresponding to an overall SIR of 1.40 (95% confidence interval (CI): 1.32–1.47). During the first 6 months following the bacteremia diagnosis, the SIR for cancer was 3.33-fold (95% CI: 2.99–3.69) increased, corresponding to an absolute risk of 3.05%. The increased risk stemmed mainly from higher than expected occurrence of gastrointestinal cancer (3- to 13-fold higher), genitourinary cancer (4- to 10-fold higher), non-Hodgkin lymphoma (5-fold higher), non-specified metastatic cancer (5-fold higher), and breast and lung cancer (2-fold higher). The 6–12 months SIR for any cancer was 1.46 (95% CI: 1.22–1.72), and beyond 1 year of follow-up, the SIR declined to 1.13 (95% CI: 1.05–1.20).
Conclusions |
Gram-negative bacteremia is a clinical marker of occult cancer.
Le texte complet de cet article est disponible en PDF.Highlights |
• | Gram-negative bacteremia is a clinical marker of occult cancer. |
• | The absolute risk of cancer within the first 6 months after bacteremia was 3%. |
• | The overall risk of cancer subsequent to bacteremia was 40% higher than expected. |
Keywords : Bacteremia, Neoplasm, Risk
Plan
Vol 74 - N° 2
P. 153-162 - février 2017 Retour au numéro
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