Although Asian people have the lowest incidence and mortality rates of prostate cancer in the world, these rates have risen rapidly in the past two decades in most Asian countries. Prostate cancer has become one of the leading male cancers in some Asian countries. In 2000, the age-adjusted incidence was over 10 per 100000 men in Japan, Taiwan, Singapore, Malaysia, the Philippines and Israel. Although some of the increases may result from enhanced detection, much of the increased incidence may be associated with westernization of the lifestyle, with increasing obesity and increased consumption of fat. The differences in incidences between native Americans and Asian immigrants are getting smaller, reflecting a possible improvement of diagnostic efforts and changes of environmental risk factors in Asian immigrants. Nevertheless, the huge variations in incidences among ethnic groups imply that there are important genetic risk factors. The stage distributions of prostate cancer in Asian populations are still unfavorable compared to those of Western developed countries. However, a trend towards diagnosing cancer with more favorable prognosis is seen in most Asian countries. Both genetic and environmental risk factors responsible for elevated risks in Asian people are being identified, which may help to reduce prostate cancer incidence in a chemopreventive setting.

Epidemiologic studies investigating the differences in respiratory outcomes between asthma–chronic obstructive pulmonary disease overlap syndrome (ACOS) and chronic obstructive pulmonary disease (COPD) in an Asian population are lacking.We conducted a population-based cohort study to compare the incidence of acute respiratory events between ACOS and COPD cohorts in Taiwan. This study investigated the incidence of acute respiratory events, namely, pneumonia, acute exacerbation, acute respiratory failure, and cardiopulmonary arrest, in 8571 patients with physician-diagnosed ACOS between 2000 and 2007 from the Longitudinal Health Insurance Database. The comparison cohort comprised 17,088 COPD patients, frequency-matched according to age, sex, and the index-year. The duration of follow-up was measured for each patient from the index date to 5 years thereafter. We used univariable and multivariable Poisson regression models to analyze the risk of acute respiratory events by including the variables of sex, age, and comorbidity.The overall prevalence of ACOS was approximately 17.4% in patients with COPD. The prevalence of ACOS increased with age. During the 5-year follow-up, a greater incidence of acute respiratory events was observed in the ACOS cohort than in the COPD cohort (11.5 and 4.62, per 100 person-years, respectively) with an adjusted incidence rate ratio (IRR) of 1.72 (95% confidence interval [CI] = 1.63–1.81). Compared with the COPD cohort, the ACOS patients had a 1.13-fold adjusted IRR of pneumonia (95% CI = 1.07–1.20) and a 2.58-fold adjusted IRR of acute exacerbation (95% CI = 2.43–2.74). Clinicians should be aware of frequent exacerbation of ACOS and prescribe appropriate treatment.

This study investigated whether an association exists between irritable bowel syndrome (IBS) and the risk of Parkinson's disease. This is a retrospective cohort study using the dataset of the Taiwan National Health Insurance Program from 2000 to 2010. We identified 23,875 patients (aged 20 years or older) with newly diagnosed IBS as the IBS group and 95,500 subjects without IBS as the non-IBS group for comparison. The main outcome was incident Parkinson's disease compared between both groups by the end of 2010. We measured the hazard ratio (HR) to evaluate the association between IBS and Parkinson's disease. The overall incidence of Parkinson's disease in the IBS group was 1.76-fold higher than that in the non-IBS group (16.4 vs. 9.33 per 10,000 person-years). The multivariable Cox proportional hazards regression analysis revealed that the adjusted HR of Parkinson's disease associated with IBS was 1.48 (95% CI 1.27, 1.72), compared with the non-IBS group. Age, women, hypertension, dementia, cerebrovascular disease and depression were also significantly associated with Parkinson's disease. Patients with irritable bowel syndrome are at an increased risk of developing Parkinson's disease. Further studies are required to explore the pathophysiological connection between these disorders.

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The current population-based study demonstrated that migraine is associated with an increased risk of IBS after adjusting for comorbidities, particularly in the young population.

The purpose of current study aims to investigate the development and progression of diabetic retinopathy (DR) in patients with diabetic nephropathy (DN) in a nationwide population-based cohort in Taiwan. Newly diagnosed DN patients and age- and sex-matched controls were identified from the Taiwanese Longitudinal Health Insurance Database from 2000 to 2010. We studied the effects of age, sex, hypertension, dyslipidemia, diabetic polyneuropathy (DPN), and medications on the development of nonproliferative DR (NPDR), proliferative DR (PDR), and diabetic macular edema (DME) in patients with DN. Cox proportional hazard regression analyses were used to estimate the adjusted hazard ratios (HRs) of the development of DR. Our results show that the adjusted HRs of NPDR and PDR were 5.01 (95% confidence interval (CI) = 4.68–5.37) and 9.7 (95% CI = 8.15–11.5), respectively, in patients with DN as compared with patients in the non-DN cohort. At 5-year follow-up, patients with DN showed an increased HR of NPDR progression to PDR (HR = 2.26, 95% CI = 1.68–3.03), and the major comorbidities were hypertension (HR = 1.23, 95% CI = 1.10–1.38 with NPDR; HR = 1.33, 95% CI = 1.02–1.72 with PDR) and DPN (HR = 2.03, 95% CI = 1.72–2.41 in NPDR; HR = 2.95, 95% CI = 2.16–4.03 in PDR). Dyslipidemia increased the HR of developing NPDR but not PDR or DME. Moreover, DN did not significantly affect DME development (HR = 1.47, 95% CI = 0.87–2.48) or progression (HR = 0.37, 95% CI = 0.11–1.20). We concluded that DN was an independent risk factor for DR development and progression; however, DN did not markedly affect DME development in this study, and the potential association between these disorders requires further investigation.