1372P - Risk of cancer in patients with autism spectrum disorder: a nationwide population-based longitudinal study

Date 28 September 2014
Event ESMO 2014
Session Poster Display session
Topics Cancer Aetiology, Epidemiology, Prevention
Cancer in Special Situations
Presenter Huey-Ling Chiang
Citation Annals of Oncology (2014) 25 (suppl_4): iv481-iv485. 10.1093/annonc/mdu352
Authors H. Chiang1, C. Teng2
  • 1Psychiatry, Far Eastern Memorial Hospital, 220 - New Taipei City/TW
  • 2Division Of Oncology And Hematology, Department Of Medicine, Far Eastern Memorial Hospital, 220 - New Taipei City/TW

Abstract

Aim

We conducted a national cohort study of autism spectrum disorder (ASD) to investigate whether individuals with ASD have an increased risk for cancer relative to the general population.We conducted a national cohort study of ASD to investigate whether individuals with ASD have an increased risk for cancer relative to the general population.

Methods

We enrolled patients with ASD from the Taiwan National Health Insurance database in years 1997–2011. A total of 8,438 patients diagnosed with ASD were retrieved from the Registry for Catastrophic Illness Patients database. The diagnosis of cancers was also based on the certificate of catastrophic illness, which requires histological confirmation. The risk of cancer among the ASD cohort was determined with the standardized incidence ratio (SIR), which is defined as the observed number of cancer occurrences divided by the expected number.

Results

The cohort was observed for 76,332 person-years. During the observation period, cancer occurred in 20 individuals with ASD, which was significantly higher than a total number of expected cancers with an SIR estimate of 1·94 (95% CI, 1·18 to 2·99). The number of cancer in males was greater than the expected number with SIR of 1·95 (1·11 to 3·16), but no excess risk was found for females. Cancer developed more than expected in individuals with age 15–19 with the SIR of 3·58 (1·44 to 7·38), but did not differ in other age range groups. The number of cancers of genitourinary system was significantly in excess of the expected number (SIR, 4·15; 95% CI, 1·13 to 10·65), and increased risk was found in ovarian cancer with SIR of 9·21 (1·12 to 33·29).

Standardized incidence ratios (SIR) for specific cancer type

Total Male Female
Cancer site Observed Expected SIR (95% CI) Observed Expected SIR (95% CI) Observed Expected SIR (95% CI)
All cancers 20 10.31 1.94 (1.18–2.99)** 16 8.21 1.95 (1.11–3.16)* 4 2.10 1.91 (0.52–4.88)
Hematologic 6 3.87 1.55 (0.57–3.37) 5 3.32 1.51 (0.49–3.52) 1 0.55 1.81 (0.05–10.07)
Leukemia 5 2.44 2.05 (0.67–4.79) 4 2.09 1.91 (0.52–4.89) 1 0.34 2.90 (0.07–16.16)
Lymphoma 1 1.42 0.71 (0.02–3.93) 1 1.21 0.83 (0.02–4.61) 0 0.21 0 (0–17.71)
CNS 3 1.70 1.77 (0.36–5.17) 3 1.46 2.05 (0.42–6.00) 0 0.23 0 (0–15.80)
Eye 1 0.11 9.44 (0.24–52.59) 1 0.09 10.61 (0.27–59.13) 0 0.01 0 (0–315.08)
Head and neck 1 0.57 1.77 (0.04–9.85) 0 0.48 0 (0–7.75) 1 0.09 11.17 (0.28–62.26)
Bone and Soft tissue 2 0.96 2.09 (0.25–7.56) 2 0.79 2.52 (0.31–9.12) 0 0.16 0 (0–22.55)
Genitourinary 4 0.96 4.16 (1.13–10.65)* 0 0.19 0 (0–19.43) 2 0.31 6.38 (0.77–23.06)
Cervix 0 0.03 0 (0–120.93) 0 0.03 0 (0–120.93)
Uterus 0 0.03 0 (0–108.33) 0 0.03 0 (0–108.33)
Ovary 2 0.22 9.22(1.12–33.29)* 2 0.22 9.22 (1.12–33.29)
Testis 2 0.46 4.33 (0.52–15.65) 2 0.46 4.33 (0.52–15.65)
Bladder 0 0.05 0 (0–75.33) 0 0.04 0 (0–82.13) 0 0.00 0 (0–909.88)
Kidney 0 0.17 0 (0–21.72) 0 0.14 0 (0–25.95) 0 0.03 0 (0–133.13)
Breast 0 0.15 0 (0–23.89) 0 0.00 0 (0–1027.53) 0 0.15 0 (0–24.46)
Digestive 2 0.67 2.99 (0.36–10.8) 2 0.55 3.67 (0.44–13.25) 0 0.12 0 (0–29.76)
Esophagus 0 0.01 0 (0–574.55) 0 0.01 0 (0–585.79) 0 0.00 0 (0–29941.96)
Stomach 0 0.05 0 (0–69.27) 0 0.04 0 (0–95.17) 0 0.01 0 (0–254.55)
Colon and rectum 0 0.24 0 (0–15.59) 0 0.18 0 (0–20.20) 0 0.05 0 (0–68.36)
Liver and biliary tract 2 0.34 5.89 (0.71–21.27) 2 0.30 6.67 (0.81–24.09) 0 0.04 0 (0–92.84)
Pancreas 0 0.03 0 (0–111.15) 0 0.02 0 (0–210.19) 0 0.02 0 (0–235.88)
Lung and mediastinum 1 0.22 4.53 (0.11–25.26) 1 0.19 5.15 (0.13–28.68) 0 0.03 0 (0–140.17)
Skin 0 0.13 0 (0–27.36) 0 0.10 0 (0–36.38) 0 0.03 0 (0–110.32)
Thyroid 0 0.56 0 (0–6.55) 0 0.23 0 (0–16.33) 0 0.34 0 (0–10.93)

CI, confidence interval; SIR, standardized incidence ratio; CNS denotes central nervous system. *P < 0.05. **P < 0.01.

Conclusions

Our study demonstrated that patients with ASD had increased risk of overall cancers, especially in males and at the age range of 15–19.

Disclosure

All authors have declared no conflicts of interest.