Cancers Preceding Parkinson’s Disease after Adjustment for Bias in a Danish Population-Based Case-Control Study

Cui, Xin; Liew, Zeyan; Hansen, Johnni; Lee, Pei‐Chen; Arah, Onyebuchi A.; Ritz, Beate

doi:10.1159/000494292

Cited by 18 publications

(18 citation statements)

References 34 publications

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“…PD patients have previously been associated with a reduced risk of cancer (20). Conversely, cancer patients have been reported to have a lower risk of developing PD, even after controlling for cancer-related lifestyle factors and correcting for survival bias (21). Recently, an inverse relationship between cancer and memory decline was reported in a large population-based cohort of Alzheimer's disease patients (22).…”

Section: Discussionmentioning

confidence: 99%

Skin Cancer May Delay Onset but Not Progression of Parkinson's Disease: A Nested Case-Control Study

et al. 2020

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Objective: To evaluate the extent to which cancer, a biological opposite to neurodegenerative disorders, may affect the onset and progression of Parkinson's disease (PD). Methods: A nested case-control design in consecutive PD patients with (cases) vs. without (controls) cancer was used to compare time to clinical diagnosis and time to Hoehn & Yahr (H&Y) staging score ≥ 3 as a measure of progression. Further, we compared PD onset and progression between cases with cancer diagnosis before (cancer before PD group) and after (cancer after PD group) PD onset. Independent variables were age at PD onset, motor subscale of the Movement Disorders Society-Unified Parkinson's Disease Rating Scale, sex, cognitive impairment, falls, depression, anxiety, dementia, and autonomic symptoms. Time to H&Y ≥ 3 was determined using Cox proportional hazards, with adjusted results summarized as hazards ratio (HR). Group differences were evaluated using unpaired t-test or Fisher's exact test. Results: The clinical PD onset was later in cases vs. controls (median 67.2 vs. 59.8 years; p < 0.001), but the adjusted time to H&Y ≥ 3 was similar between groups (HR = 0.67; p = 0.13). Skin cancers constituted 75% of all cancers in cases. Amongst skin cancers, compared to controls, cases had an older age at PD onset (67.8 vs. 59.8 years; p < 0.001). There was no difference in risk of progression in PD patients with skin cancer compared to controls (HR = 0.54, p = 0.09). Conclusions: Cancer, in particular of the skin, may delay the onset but not the progression of PD. Future prospective observational studies are warranted to elucidate the complex interactions between these biologically divergent disorders.

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Section: Discussionmentioning

confidence: 99%

Skin Cancer May Delay Onset but Not Progression of Parkinson's Disease: A Nested Case-Control Study

et al. 2020

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“…Considering the vast number of existing cohort studies, they could become an invaluable source of useful bias parameters for the populations they were sampled from. New examples in the literature suggest that the opposite procedure might also be useful : correcting biases in case-control or cohort studies using population-based register data ( 32 , 33 ). Further, even more general approaches to combining data from several data sources with different biases have been recently formalized ( 34 ).…”

Section: Discussionmentioning

confidence: 99%

Probabilistic Quantification of Bias to Combine the Strengths of Population-Based Register Data and Clinical Cohorts—Studying Mortality in Osteoarthritis

Turkiewicz¹,

Nilsson²,

Kiadaliri³

2020

American Journal of Epidemiology

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Abstract We propose to combine population-based register data, with a nested clinical cohort to correct misclassification and unmeasured confounding through probabilistic quantification of bias. We illustrate this approach by estimating the association between knee osteoarthritis and mortality. We used the Swedish Population Register to include all persons resident in the Skåne region in 2008 and assessed if they had osteoarthritis using data from the Skåne Healthcare Register. We studied mortality until year 2017 by estimating hazard ratios (HR). We used data from the Malmö Osteoarthritis Study (MOA), a small cohort study from Skåne, to derive bias parameters for probabilistic quantification of bias, to correct the HR estimate for differential misclassification of the knee osteoarthritis diagnosis and confounding from unmeasured obesity. We included 292,000 persons in the Skåne population and 1419 from the MOA study. The adjusted association of knee osteoarthritis with all-cause mortality in the MOA sample was (HR [95% confidence interval]) 1.10 (0.80,1.52) and thus inconclusive. The naive association in the Skåne population was 0.95(0.93,0.98), while the bias-corrected estimate was 1.02 (0.59,1.52), suggesting high uncertainty in bias correction. Combining population-based register data with clinical cohorts provide more information than using either data source separately.

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“…Several types of melanomas are recognized, including those that arise from pre-existing moles (superficial spreading melanoma), de novo (nodular melanoma), from precursor lentigo maligna (lentigo maligna melanoma), or present under nail beds or on the palms or soles (acral lentiginous melanoma). The relationship between melanoma and PD has been studied for a long time as several epidemiological studies have demonstrated increased risk of melanoma in patients with PD although the risk of other cancers is lower than expected [19][20][21][22][23][24][25], even after correcting for confounders known to reduce the risk of PD, such as smoking [26]. Mahajan and colleagues recently conducted a single-center, nested case-control study and found that cancer, especially skin cancer, was associated with delayed onset of PD, although the clinical progression was unaffected [27].…”

Section: Melanomamentioning

confidence: 99%

Parkinson's disease and skin

Niemann

Billnitzer

Jankovic

2021

Parkinsonism & Related Disorders

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Parkinson's disease is associated with a variety of dermatologic disorders and the study of skin may provide insights into pathophysiological mechanisms underlying this common neurodegenerative disorder. Skin disorders in patients with Parkinson's disease can be divided into two major groups: 1) non-iatrogenic disorders, including melanoma, seborrheic dermatitis, sweating disorders, bullous pemphigoid, and rosacea, and 2) iatrogenic disorders related either to systemic side effects of antiparkinsonian medications or to the delivery system of antiparkinsonian therapy, including primarily carbidopa/levodopa, rotigotine and other dopamine agonists, amantadine, catechol-O-methyl transferase inhibitors, subcutaneous apomorphine, levodopa/carbidopa intestinal gel, and deep brain stimulation. Recent advances in our understanding of the role of α-synuclein in peripheral tissues, including the skin, and research based on induced pluripotent stem cells derived from skin fibroblasts have made skin an important target for the study of Parkinson's disease pathogenesis, drug discovery, novel stem cell therapies, and diagnostics.

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Cancers Preceding Parkinson’s Disease after Adjustment for Bias in a Danish Population-Based Case-Control Study

Cited by 18 publications

References 34 publications

Skin Cancer May Delay Onset but Not Progression of Parkinson's Disease: A Nested Case-Control Study

Skin Cancer May Delay Onset but Not Progression of Parkinson's Disease: A Nested Case-Control Study

Probabilistic Quantification of Bias to Combine the Strengths of Population-Based Register Data and Clinical Cohorts—Studying Mortality in Osteoarthritis

Parkinson's disease and skin

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