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  • Similar to our findings increased prevalence of

    2019-08-16

    Similar to our findings, increased prevalence of abdominal obesity, as well as increased triglyceride and HDL levels, were reported in breast cancer survivors [12]. Studies also reported increased prevalence of high HDL levels in breast cancer survivors [7,12], however, the HDL difference was not statistically significant in our study. The fact that a few studies have assessed the prevalence of individual MeS components in site-specific cancer survivors makes our study unique. This study had several limitations. First, due to its cross-sectional study design, there was the potential for temporal bias and causal relations could not be determined. Considering that MeS is one of the risk factors for cancer development [52], the increased prevalence of MeS in cancer survivors could include MeS which developed before the cancer diagnosis. In addition, the cross-sectional study design may lead to exclusion of cancer survivors with MeS who died before the study, which may skew the results towards favorable outcomes [54]. About one-third of the cancer survivors were under treatment at the time of survey and 50% had been diagnosed within the past five years. The definition of cancer survivors widely includes cancer patients from their diagnosis [55], and study participants were included from local health examination centers and not the oncology unit or cancer care center and were capable of completing the interview and attending routine health check-ups, including blood tests, by themselves. In addition, the prevalence of MeS according treatment status or years from diagnosis did not show statistically significant differences. Thus, we considered all cancer survivors as being capable of returning to the community, irrespective of their treatment status or years since diagnosis and this Tadalafil might not affect the result. Combining several kinds of chronic diseases into one group, CDZ, is a limitation of our study, considering the different associations between each chronic disease with MeS [[22], [23], [24], [25], [26], [27], [28], [29], [30], [31], [32], [33], [34], [35], [36], [37], [38]]. When we compared the prevalence of MeS according to the presence of each chronic disease, it was quite different for different disease types (data not shown). Considering that the definition of chronic disease itself includes various types of diseases, including cancer [56], the common feature of which is a medical condition that lasts several months and requires ongoing medical attention [[57], [58], [59]], combining them into a single group (CDZ) would be acceptable despite heterogeneity in the prevalence of MeS. In addition, some of the chronic diseases, including hypertension, diabetes, and dyslipidemia, which we included in the CDZ are components of MeS that were associated with increased MeS prevalence. When we excluded people who reported having all three conditions (hypertension, diabetes, and dyslipidemia), the prevalence of MeS (30.7%) was comparable to the current result (32.0%). All subjects underwent routine health examinations, so might have had more interest and a better understanding of their health status. Thus, the study population may not be representative of the entire Korean population or cancer survivors in Korea. However, the cancer prevalence in our study population was comparable with the results of the Korean Cancer Registry [60]. In addition, despite the limited generalizability, we tried to make the comparability better that of previous studies by selecting cancer survivors and controls from the same source and matching them by age and gender. Differences due to various treatment regimen strategies or stage of cancer could not be analyzed owing to lack of information. Additionally, information bias due to the self-reported questionnaire should be considered in cancer survivor and adjusted variables’ definition. Moreover, health behavior changes that occurred after the survey could not be included in the analysis. Despite these limitations, to our knowledge, this is the first study to investigate the prevalence of MeS in cancer survivors who have returned to their normal lives and health status within the general population in the community.