Protective Effects of Influenza Vaccine against Colorectal Cancer in Populations with Chronic Kidney Disease: A Nationwide Population-Based Cohort Study

Author:

Chen Chun-Chao1234ORCID,Hao Wen-Rui123ORCID,Hong Hong-Jye5,Lin Kuan-Jie26,Chiu Chun-Chih12,Yang Tsung-Yeh12,Fang Yu-Ann12,Jian William7,Chen Ming-Yao8910,Hsu Min-Huei1112,Lu Shih-Chun113,Lai Yu-Hsin8910,Yang Tsung-Lin2314,Liu Ju-Chi123

Affiliation:

1. Division of Cardiology, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City 23561, Taiwan

2. Taipei Heart Institute, Taipei Medical University, Taipei 11031, Taiwan

3. Division of Cardiology, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan

4. Graduate Institute of Medical Sciences, College of Medicine, Taipei Medical University, Taipei 110301, Taiwan

5. School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung City 404333, Taiwan

6. Division of Cardiovascular Surgery, Department of Surgery, Shuang Ho Hospital, Taipei Medical University, New Taipei City 23561, Taiwan

7. Department of Emergency, University Hospitals Cleveland Medical Center, Cleveland, OH 44106, USA

8. Division of Gastroenterology and Hepatology, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei 110301, Taiwan

9. TMU Research Center for Digestive Medicine, Taipei Medical University, Taipei 110301, Taiwan

10. Division of Gastroenterology and Hepatology, Department of Internal Medicine, Shuang Ho Hospital, New Taipei City 23561, Taiwan

11. Graduate Institute of Data Science, College of Management, Taipei Medical University, Taipei 110301, Taiwan

12. Department of Neurosurgery, Shuang Ho Hospital, Taipei Medical University, New Taipei City 23561, Taiwan

13. Department of Surgery, MacKay Memorial Hospital, Taipei 10449, Taiwan

14. Division of Cardiology, Department of Internal Medicine and Cardiovascular Research Center, Taipei Medical University Hospital, Taipei 110301, Taiwan

Abstract

Chronic kidney disease (CKD) is associated with malignancy, including colorectal cancer, via the potential mechanism of chronic inflammation status. This study aimed to determine whether influenza vaccines can reduce the risk of colorectal cancer in patients with CKD. Our cohort study enrolled 12,985 patients older than 55 years with a diagnosis of CKD in Taiwan from the National Health Insurance Research Database at any time from 1 January 2001 to 31 December 2012. Patients enrolled in the study were divided into a vaccinated and an unvaccinated group. In this study, 7490 and 5495 patients were unvaccinated and vaccinated, respectively. A propensity score was utilized to reduce bias and adjust the results. Cox proportional hazards regression was used to estimate the correlation between the influenza vaccine and colorectal cancer in patients with CKD. The results showed that the influenza vaccine exerted a protective effect against colorectal cancer in populations with CKD. The incidence rate of colon cancer in the vaccinated group was significantly lower than in the unvaccinated group, with an adjusted hazard rate (HR) of 0.38 (95% CI: 0.30–0.48, p < 0.05). After the propensity score was adjusted for Charlson comorbidity index, age, sex, dyslipidemia, hypertension, diabetes, monthly income, and level of urbanization, the dose-dependent effect was found, and it revealed adjusted HRs of 0.74 (95% CI: 0.54–1.00, p < 0.05), 0.41 (95% CI: 0.30–0.57, p < 0.001), 0.16 (95% CI: 0.11–0.25, p < 0.001) for one, two to three, and four or more vaccinations, respectively. In summary, the influenza vaccine was found to be associated with a reduced risk of colorectal cancer in CKD patients. This study highlights the potential chemopreventive effect of influenza vaccination among patients with CKD. Future studies are required to determine whether the aforementioned relationship is a causal one.

Funder

Ministry of Education (MOE) in Taiwan

Taipei Medical University-Shuang Ho Hospital, Ministry of Health and Welfare

Publisher

MDPI AG

Subject

Cancer Research,Oncology

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