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Parkinson’s disease and cancer risk: a systematic review and meta-analysis

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Abstract

Objective

To appraise the existing literature on cancer risk among patients with Parkinson’s disease (PD), determine the overall cancer risk ratio among patients with PD, explore reasons for variations in study results, and assess the potential for publication bias.

Methods

Studies reporting cancer risk in patients with PD were identified by searching electronic databases through 18 November 2009 using the terms PARKINSON DISEASE, NEOPLASM, and CANCER. Reviewers individually performed data extraction and scored each study using a quality assessment instrument. Cancer risk in all patients with PD was calculated overall, and after excluding melanoma and other skin cancers. We tested for heterogeneity and publication bias, and stratified for gender, smoking-related versus non-smoking-related cancers, and study quality. We pooled effect sizes using fixed-effects and random-effects models.

Results

We included 29 studies in the overall analysis for a total of 107,598 patients with PD. Compared to controls, the aggregate risk for cancer in patients with PD was 0.73 (95% confidence interval [CI], 0.63–0.83), and after excluding skin tumors, 0.69 (95% CI, 0.62–0.78). These risks varied by gender (males, RR = 0.71, 95% CI, 0.57–0.88; females, RR = 0.82; 95% CI, 0.68–0.98). After strictly excluding skin tumors, both smoking-related (RR = 0.61; 95% CI, 0.58–0.65) and non-smoking-related cancer rates (RR = 0.76; 95% CI, 0.65–0.89) were significantly lower among patients with PD .

Conclusions

Studies on cancer risk among patients with PD collectively show significantly reduced cancer risk ratios. Further research to explain the biological mechanisms, particularly for the association with non-smoking-related cancers, appears warranted.

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References

  1. Inzelberg R, Jankovic J (2007) Are Parkinson disease patients protected from some but not all cancers? Neurology 69(15):1542–1550

    Article  PubMed  Google Scholar 

  2. West AB, Dawson VL, Dawson TM (2005) To die or grow: Parkinson’s disease and cancer. Trends Neurosci 28(7):348–352

    Article  CAS  PubMed  Google Scholar 

  3. Staropoli JF (2008) Tumorigenesis and neurodegeneration: two sides of the same coin? Bioessays 30(8):719–727

    Article  CAS  PubMed  Google Scholar 

  4. Driver JA, Logroscino G, Buring JE, Gaziano JM, Kurth T (2007) A prospective cohort study of cancer incidence following the diagnosis of Parkinson’s disease. Cancer Epidemiol Biomarkers Prev 16(6):1260–1265

    Article  PubMed  Google Scholar 

  5. Olsen JH, Friis S, Frederiksen K (2006) Malignant melanoma and other types of cancer preceding Parkinson disease. Epidemiology 17(5):582–587

    Article  PubMed  Google Scholar 

  6. Olsen JH, Friis S, Frederiksen K, McLaughlin JK, Mellemkjaer L, Moller H (2005) Atypical cancer pattern in patients with Parkinson’s disease. Br J Cancer 92(1):201–205

    Article  CAS  PubMed  Google Scholar 

  7. Vanacore N, Spila-Alegiani S, Raschetti R, Meco G (1999) Mortality cancer risk in parkinsonian patients: a population-based study. Neurology 52(2):395–398

    CAS  PubMed  Google Scholar 

  8. Olsen JH, Tangerud K, Wermuth L, Frederiksen K, Friis S (2007) Treatment with levodopa and risk for malignant melanoma. Mov Disord 22(9):1252–1257

    Article  PubMed  Google Scholar 

  9. Stroup D, Berlin J, Morton S, Olkin I, Williamson G, Rennie D et al (2000) Meta-analysis of observational studies in epidemiology: a proposal for reporting. Meta-analysis Of Observational Studies in Epidemiology (MOOSE) group. JAMA 283:2008–2012

    Article  CAS  PubMed  Google Scholar 

  10. D’Amelio M, Ragonese P, Morgante L, Reggio A, Callari G, Salemi G et al (2006) Long-term survival of Parkinson’s disease. J Neurol 253:33–37

    Article  PubMed  Google Scholar 

  11. Elbaz A, Peterson BJ, Bower JH, Yang P, Maraganore DM, McDonnell SK et al (2005) Risk of cancer after the diagnosis of Parkinson’s disease: a historical cohort study. Mov Disord 20(6):719–725

    Article  PubMed  Google Scholar 

  12. Leibson CL, Maraganore DM, Bower JH, Ransom JE, O’Brien PC, Rocca WA (2006) Comorbid conditions associated with Parkinson’s disease: a population-based study. Mov Disord 21(4):446–455

    Article  PubMed  Google Scholar 

  13. Moller H, Mellemkjaer L, McLaughlin JK, Olsen JH (1995) Occurrence of different cancers in patients with Parkinson’s disease. BMJ 310(6993):1500–1501

    CAS  PubMed  Google Scholar 

  14. Morgante L (2000) Parkinson disease survival: a population based study. Arch Neurol 57(4):507–512

    Article  CAS  PubMed  Google Scholar 

  15. Raschetti R, Spila-Alegiani S, Vanacore N, Ancona C, Meco G (1998) Mortality in a population-based cohort of patients treated with antiparkinsonian drugs. Acta Neurol Scand 97(1):20–26

    CAS  PubMed  Google Scholar 

  16. Driver JA, Kurth T, Buring JE, Gaziano JM, Logroscino G (2007) Prospective case-control study of nonfatal cancer preceding the diagnosis of Parkinson’s disease. Cancer Causes Control 18(7):705–711

    Article  PubMed  Google Scholar 

  17. Elbaz A, Peterson BJ, Yang P, Van Gerpen JA, Bower JH, Maraganore DM et al (2002) Nonfatal cancer preceding Parkinson’s disease: a case-control study. Epidemiology 13(2):157–164

    Article  PubMed  Google Scholar 

  18. Driver JA, Kurth T, Buring JE, Gaziano JM, Logroscino G (2008) Parkinson disease and risk of mortality: a prospective comorbidity-matched cohort study. Neurology 70(16 pt 2):1423–1430

    Article  CAS  PubMed  Google Scholar 

  19. Gorell JM, Johnson CC, Rybicki BA (1994) Parkinson’s disease and its comorbid disorders: an analysis of Michigan mortality data, 1970 to 1990. Neurology 44(10):1865–1868

    CAS  PubMed  Google Scholar 

  20. Kondo K (1984) Motor neuron disease and Parkinson’s disease are not associated with other disorders at autopsy. Neuroepidemiology 3:182–194

    Article  Google Scholar 

  21. Marmot MG (1981) Mortality and Parkinson’s disease. In: Rose FC, Capildeo R (eds) Research progress in Parkinsons’ disease. Pitman Medical, Kent, pp 9–16

    Google Scholar 

  22. Pritchard PB III, Netsky MG (1973) Prevalence of neoplasms and causes of death in paralysis agitans. A necropsy study. Neurology 23(3):215–222

    PubMed  Google Scholar 

  23. Levine RL, Jones JC, Bee N (1992) Stroke and Parkinson’s disease. Stroke 23(6):839–842

    CAS  PubMed  Google Scholar 

  24. Di Rocco A, Molinari SP, Kollmeier B, Yahr MD (1996) Parkinson’s disease: progression and mortality in the l-DOPA era. Adv Neurol 69:3–11

    CAS  PubMed  Google Scholar 

  25. Vital Statistics of the United States, 1963. Hyattsville, MD: Centers for Disease Control and Prevention, National Center for Health Statistics; 1965

  26. The health consequences of smoking: a report of the surgeon general. Atlanta, GA: Centers for Disease Control and Prevention, Office on Smoking and Health; 2004

  27. Walker AM (1991) Observation and inference: an introduction to the methods of epidemiology. Newton Lower Falls, Epidemiology Resources Inc

  28. DerSimonian R, Laird N (1986) Meta-analysis in clinical trials. Control Clin Trials 7:177–188

    Article  CAS  PubMed  Google Scholar 

  29. Cochran WG (1954) Some methods for strengthening the common χ2 tests. Biometrics 10(4):417–451

    Article  Google Scholar 

  30. Takkouche B, Cadarso-Suarez C, Spiegalman D (1999) Evaluation of old and new tests of heterogeneity in epidemiologic meta-analysis. Am J Epidemiol 150:206–215

    CAS  PubMed  Google Scholar 

  31. Begg CB, Mazumdar M (1994) Operating characteristics of a rank correlation test for publication bias. Biometrics 50(4):1088–1101

    Article  CAS  PubMed  Google Scholar 

  32. Egger M, Davey SG, Schneider M, Minder C (1997) Bias in meta-analysis detected by a simple, graphical test. BMJ 315(7109):629–634

    CAS  PubMed  Google Scholar 

  33. Stata commands for meta-analyses. STATA 2001. [online]. Available at: www.stata.com

  34. Barbeau A, Joly JG (1963) Parkinson et cancer. Union Med Can 92:169–174

    CAS  PubMed  Google Scholar 

  35. Guttman M, Slaughter PM, Theriault ME, DeBoer DP, Naylor CD (2004) Parkinsonism in Ontario: comorbidity associated with hospitalization in a large cohort. Mov Disord 19(1):49–53

    Article  PubMed  Google Scholar 

  36. Jansson B, Jankovic J (1985) Low cancer rates among patients with Parkinson’s disease. Ann Neurol 17(5):505–509

    Article  CAS  PubMed  Google Scholar 

  37. Minami Y, Yamamoto R, Nishikouri M, Fukao A, Hisamichi S (2000) Mortality and cancer incidence in patients with Parkinson’s disease. J Neurol 247(6):429–434

    Article  CAS  PubMed  Google Scholar 

  38. Pressley JC, Louis ED, Tang MX, Cote L, Cohen PD, Glied S et al (2003) The impact of comorbid disease and injuries on resource use and expenditures in parkinsonism. Neurology 60(1):87–93

    CAS  PubMed  Google Scholar 

  39. Fois AF, Wotton CJ, Yeates D, Turner MR, Goldacre MJ (2009) Cancer in patients with motor neuron disease, multiple sclerosis, and Parkinson’s disease: record-linkage studies. J Neurol Neurosurg Psychiatry

  40. D’Amelio M, Ragonese P, Morgante L, Epifanio A, Callari G, Salemi G et al (2004) Tumor diagnosis preceding Parkinson’s disease: a case-control study. Mov Disord 19(7):807–811

    Article  PubMed  Google Scholar 

  41. Powers KM, Smith-Weller T, Franklin GM, Longstreth WT Jr, Swanson PD, Checkoway H (2006) Diabetes, smoking, and other medical conditions in relation to Parkinson’s disease risk. Parkinsonism Relat Disord 12(3):185–189

    Article  PubMed  Google Scholar 

  42. Rajput AH, Offord KP, Beard CM, Kurland LT (1987) A case-control study of smoking habits, dementia, and other illnesses in idiopathic Parkinson’s disease. Neurology 37(2):226–232

    CAS  PubMed  Google Scholar 

  43. Ben-Shlomo Y, Marmot MG (1995) Survival and cause of death in a cohort of patients with Parkinsonism: possible clues to aetiology? J Neurol Neurosurg Psychiatry 58(3):293–299

    Article  CAS  PubMed  Google Scholar 

  44. Beyer MK, Herlofson K, Arsland D, Larsen JP (2001) Causes of death in a community-based study of Parkinson’s disease. Acta Neurol Scand 103(1):7–11

    Article  CAS  PubMed  Google Scholar 

  45. Fall PA, Saleh A, Fredrickson M, Olsson JE, Granerus AK (2003) Survival time, mortality, and cause of death in elderly patients with Parkinson’s disease: a 9-year follow-up. Mov Disord 18(11):1312–1316

    Article  PubMed  Google Scholar 

  46. Harada H, Nishikawa S, Takahashi K (1983) Epidemiology of Parkinson’s disease in a Japanese city. Arch Neurol 40(3):151–154

    CAS  PubMed  Google Scholar 

  47. Hely MA, Morris JG, Traficante R, Reid WG, O’Sullivan DJ, Williamson PM (1999) The Sydney multicentre study of Parkinson’s disease: progression and mortality at 10 years. J Neurol Neurosurg Psychiatry 67(3):300–307

    Article  CAS  PubMed  Google Scholar 

  48. Hoehn MM, Yahr MD (1967) Parkinsonism: onset, progression and mortality. Neurology 17(5):427–442

    CAS  PubMed  Google Scholar 

  49. Kessler II (1972) Epidemiologic studies of Parkinson’s disease. II. A hospital-based survey. Am J Epidemiol 95(4):308–318

    CAS  PubMed  Google Scholar 

  50. Louis ED, Marder K, Cote L, Tang M, Mayeux R (1997) Mortality from Parkinson’s disease. Arch Neurol 54(3):260–264

    CAS  PubMed  Google Scholar 

  51. Wermuth L, Stenager EN, Stenager E, Boldsen J (1995) Mortality in patients with Parkinson’s disease. Acta Neurol Scand 92(1):55–58

    Article  CAS  PubMed  Google Scholar 

  52. Westlund K, Hougen A (1956) Cancer as a cause of death among patients with other chronic diseases. J Am Med Assoc 162:1003

    Google Scholar 

  53. SEER Cancer Statistics Review. 1975-2005. Natl Cancer Inst. [online]. Available at http://seer.cancer.gov

  54. Riggs JE (1999) Mortality cancer risk in parkinsonian patients: a population-based study. Neurology 53(5):1158–1159

    CAS  PubMed  Google Scholar 

  55. Hernan MA, Takkouche B, Caamano-Isorna F, Gestal-Otero JJ (2002) A meta-analysis of coffee drinking, cigarette smoking, and the risk of Parkinson’s disease. Ann Neurol 52:276–284

    Article  PubMed  Google Scholar 

  56. McNaught KS, Perl DP, Brownell AL, Olanow CW (2004) Systemic exposure to proteasome inhibitors causes a progressive model of Parkinson’s disease. Ann Neurol 56(1):149–162

    Article  CAS  PubMed  Google Scholar 

  57. Montagut C, Rovira A, Albanell J (2006) The proteasome: a novel target for anticancer therapy. Clin Transl Oncol 8(5):313–317

    Article  CAS  PubMed  Google Scholar 

  58. Schernhammer E, Chen H, Ritz B (2006) Circulating melatonin levels: possible link between Parkinson’s disease and cancer risk? Cancer Causes Control 17(4):577–582

    Article  PubMed  Google Scholar 

  59. Zanetti R, Loria D, Rosso S (2006) Melanoma, Parkinson’s disease and levodopa: causal or spurious link? A review of the literature. Melanoma Res 16(3):201–206

    Article  CAS  PubMed  Google Scholar 

  60. Fiala KH, Whetteckey J, Manyam BV (2003) Malignant melanoma and levodopa in Parkinson’s disease: causality or coincidence? Parkinsonism Relat Disord 9(6):321–327

    Article  PubMed  Google Scholar 

  61. Cancer Statistics 2008, American Cancer Society. [online]. Available at: http://www.cancer.org/docroot/PRO/content/PRO_1_1_Cancer_Statistics_2008_Presentation.asp

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Conflict of interest statement

All authors declare no disclosures and no financial conflicts of interest.

Author information

Authors and Affiliations

  1. Channing Laboratory, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, 181 Longwood Avenue, Boston, MA, 02115, USA

    Archna Bajaj & Eva S. Schernhammer

  2. Case Western Reserve University School of Medicine, Cleveland, OH, USA

    Archna Bajaj

  3. Division of Aging, Department of Medicine, Brigham and Women’s Hospital, Boston, MA, USA

    Jane A. Driver

  4. Geriatric Research, Education and Clinical Center, Boston VA Healthcare System, Boston, MA, USA

    Jane A. Driver

  5. Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA

    Eva S. Schernhammer

  6. LBI-ACR-CTO & ACR-ITR VIEnna/CEADDP, Vienna, Austria

    Eva S. Schernhammer

Authors
  1. Archna Bajaj
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  2. Jane A. Driver
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  3. Eva S. Schernhammer
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Correspondence to Archna Bajaj.

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Bajaj, A., Driver, J.A. & Schernhammer, E.S. Parkinson’s disease and cancer risk: a systematic review and meta-analysis. Cancer Causes Control 21, 697–707 (2010). https://doi.org/10.1007/s10552-009-9497-6

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  • DOI: https://doi.org/10.1007/s10552-009-9497-6

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