Alzheimer’s and Parkinson’s Diseases and the Risk of Cancer: A Cohort Study

Article type: Research Article

Authors: Ording, Anne G.^{a; *} | Veres, Katalin^a | Horváth-Puhó, Erzsébet^a | Glymour, M. Maria^b | Rørth, Mikael^a | Henderson, Victor W.^{a; c; d} | Sørensen, Henrik T.^{a; c}

Affiliations: [a] Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark | [b] Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA | [c] Department of Epidemiology and Population Health, Stanford University, Stanford, CA, USA | [d] Department of Neurology and Neurological Sciences, Stanford University, Stanford, CA, USA

Correspondence: [*] Correspondence to: Anne Gulbech Ording, PhD, Department of Clinical Epidemiology, Aarhus University Hospital, Olof Palme’s Allé 43-45, DK-8200 Aarhus N, Denmark. Tel.: +45 871 67212; Fax: +45 871 67215; E-mail: ao@clin.au.dk.

Abstract:  Observational studies have shown inverse associations between neurological diseases, particularly dementia, and subsequent cancer risk, but is unknown whether this association is valid or arises from bias. We conducted a Danish nationwide cohort study using population-based health registries (1980–2012). The study included patients with dementia (n = 173,434) and with Parkinson’s disease (n = 28,835). We followed patients for 10 years to assess subsequent cancer diagnoses. We computed absolute reduction in cancer risk attributable to dementia or Parkinson’s disease (expected minus the observed number of cancer cases divided by the person time) and standardized incidence rate ratios (SIRs) as the observed to expected number of cancers, based on sex-, age-, and calendar year-standardized national incidence rates. During 10 years, the reduction in cancer cases were 79.9 per 10,000 person-years for Alzheimer’s disease [SIR = 0.68 (95% CI: 0.66, 0.70)], 74.4 per 10,000 person-years for vascular dementia [SIR = 0.71 (95% CI: 0.67, 0.74)], 55.8 per 10,000 person-years [SIR = 0.77 (95% CI: 0.75, 0.78)] for all-cause dementia, and 4.0 per 10,000 person-years [SIR = 0.98 (95% CI: 0.95, 1.02) for Parkinson’s disease. Associations were nearly similar for solid tumors diagnosed at localized, regional, or distant stages. We found an inverse association between dementia and cancer risk, with similar associations when considering only cancers diagnosed at distant stage. The cancer risk varied by type of dementia, with a gradient toward a stronger protective effect associated with Alzheimer’s disease and vascular dementia, which may favor a biological explanation. Overall results do not show an inverse association between Parkinson’s disease and cancer.

Keywords: Alzheimer’s disease, dementia, epidemiology, neoplasms, Parkinson’s disease, risk

DOI: 10.3233/JAD-190867

Journal: Journal of Alzheimer's Disease, vol. 72, no. 4, pp. 1269-1277, 2019