Surgery and anesthesia traumas might cause immunosuppressive events, immunosuppressive inflammation was considered to facilitate the development of cancer. Therefore, the objective of this case control study is to investigate the impact of surgery history on cancer diagnosis.
We enrolled patients who were hospitalized in the First Affiliated Hospital of Guangzhou Medical University between 2009 and 2017 and retrieved diagnosis and surgery history of each patient. To minimize potential bias, only patients less than 60 years old were included; those with multiple primary cancers, non-solid tumors and patients undergoing previous surgery for cancer resection were excluded. The primary outcome of interest was the odds ratio (OR) of cancer between surgery patients versus non-surgery patients, adjusted for sex and smoking history. Surgeries were classified as general anesthesia (GA) and local anesthesia (LA). Chi-square test and logistic regression analysis were used for analysis.
A total of 142,250 patients were included, of whom 36,579 had surgery history for benign diseases. 12,983 patients had diagnosis of cancer. Among patients with and without cancer diagnosis, the proportions of surgery history were 3,546 (27.31%) and 33,033 (25.55%), respectively. Multivariate logistic regression suggested that surgery history, male sex and smoking status (all ORs >1.000, p<0.050) were all positively associated with probability of cancer. Surgeries with GA and LA (all ORs >1.000, p<0.050) showed similar effects. Additionally, the impact of surgery history was similar among early cancer patients (OR =1.070, 95% CI, 0.998-1.147, p=0.057) and advanced cancer patients (OR =1.082, 95% CI, 1.030-1.137, p<0.050).
Our study suggests an increased cancer probability among patients with previous surgery in earlier years. This supports that surgery-related trauma might play a role in the development of cancer. Prospective cohort studies are warranted to investigate the exact correlation between surgery and cancer risk. Table: 199P
|Cancer||OR(95% CI)||P value|
|Sex (Male vs. Female)||1.048 (1.007-1.091)||<0.050|
|Smoking Status (Yes vs. No)||2.401 (2.294-2.513)||<0.001|
|Surgery History (Yes vs. No)||1.083 (1.040-1.129)||<0.001|
|GA group (GA vs. No)||1.078 (1.026-1.131)||<0.050|
|LA group(LA vs. No)||1.094 (1.028-1.164)||<0.050|
Legal entity responsible for the study
Department of Thoracic Surgery and Oncology, The First Affiliated Hospital of Guangzhou Medical University, China State Key Laboratory of Respiratory Disease & National Clinical Research Center for Respiratory Disease.
Has not received any funding.
All authors have declared no conflicts of interest.