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A Prospective Cohort Study of Cancer Incidence Following the Diagnosis of Parkinson's Disease

¹ Divisions of Aging and ² Preventive Medicine, Department of Medicine, Brigham and Women's Hospital, ³ Department of Ambulatory Care and Prevention, Harvard Medical School, ⁴ Department of Epidemiology, Harvard School of Public Health, Harvard University, and ⁵ Massachusettes Veterans Epidemiology Research and Information Center, Veterans Affairs Boston Healthcare System, Boston, Massachusetts

Requests for reprints: Tobias Kurth, Brigham and Women's Hospital Division of Aging, 1620 Tremont Street, Boston, MA 02120-1613. Phone: 617-732-8355; Fax: 617-525-7739. E-mail: tkurth{at}rics.bwh.harvard.edu

Background: Prior studies suggest a decreased risk of cancer among patients with Parkinson's disease (PD).

Methods: Matched cohort analysis among the 22,071 participants in the Physician's Health Study. A total of 487 incident cases of PD without preceding cancer were identified by self-report. Each PD case was matched by age to a reference participant who was alive and cancer free at the time of PD diagnosis. Both cohorts were followed for incident cancer. We used proportional hazards models to calculate adjusted relative risks (RR) for cancer.

Results: A total of 121 cancers were confirmed during a median follow-up of 5.2 years (PD) and 5.9 years (reference). Those with PD developed less cancer (11.0% versus 14.0%), with an adjusted RR of 0.85 [95% confidence interval (95% CI), 0.59-1.22]. Reduced risk was present for smoking-related cancers such as lung (RR, 0.32), colorectal (RR, 0.54), and bladder (RR, 0.68), as well as for most non–smoking-related cancers such as prostate cancer (RR, 0.74). In contrast, PD patients were at significantly increased risk (RR, 6.15; 95% CI, 1.77-21.37) for melanoma. PD patients who smoked were at reduced risk for smoking-related cancer (RR, 0.33; 95% CI, 0.12-0.92), whereas nonsmokers with PD were at increased risk (RR, 1.80; 95% CI, 0.60-5.39). This interaction was statistically significant (P_interaction = 0.02).

Conclusions: Our results suggest a decreased incidence of most cancers in patients with PD. PD patients had a significantly increased risk of malignant melanoma, a finding consistent with prior studies. We confirmed an interaction between smoking and the relationship of PD to smoking-related cancer that may fit the pattern of a gene-environment interaction. (Cancer Epidemiol Biomarkers Prev 2007;16(6):1260–5)

Commentary

Parkinson's Disease and Cancer

Roberto Zanetti, Stefano Rosso, and Dora I. Loria
Cancer Epidemiol. Biomarkers Prev. 2007 16: 1081. [Full Text] [PDF]

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				R. Zanetti, S. Rosso, and D. I. Loria Parkinson's Disease and Cancer Cancer Epidemiol. Biomarkers Prev., June 1, 2007; 16(6): 1081 - 1081. [Full Text] [PDF]