Infection and Drug Resistance (Jul 2022)
Epidemiology of Aspergillosis in Cancer Patients in Taiwan
Abstract
Chien-An Chen,1,2,* Chung-Han Ho,3– 5,* Yu-Cih Wu,3 Yi-Chen Chen,3 Jhi-Joung Wang,3 Kuang-Ming Liao6 1Division of Hepatogastroenterology, Department of Internal Medicine, Chi Mei Medical Center, Tainan, 71004, Taiwan; 2Division of Hospital Medicine, Department of Internal Medicine, Chi Mei Medical Center, Tainan, 71004, Taiwan; 3Department of Medical Research, Chi Mei Medical Center, Tainan, 71004, Taiwan; 4Department of Information Management, Southern Taiwan University of Science and Technology, Tainan, 71005, Taiwan; 5Cancer Center, Taipei Municipal Wanfang Hospital, Taipei Medical University, Taipei, 11696, Taiwan; 6Department of Internal Medicine, Chi Mei Medical Center, Chiali, Tainan, 72263, Taiwan*These authors contributed equally to this workCorrespondence: Kuang-Ming Liao, Department of Internal Medicine, Chi Mei Medical Center, Chiali, Tainan, 72263, Taiwan, Tel +886 6 726 3333, Email [email protected]: The incidence of aspergillosis is increasing, and the risk factors for infection include cancer, admission to the intensive care unit, chronic pulmonary diseases, immunocompromised status, and taking immunomodulatory drugs. There are limited data about the incidence of aspergillosis in patients with different types of cancer. The aim of our study was to survey the incidence of aspergillosis in different cancer types from 2006 to 2017.Patients and Methods: Data were collected from the Taiwan Cancer Registry database and International Classification of Diseases, 9th, 10th Revision, and Clinical Modification codes for diagnosing aspergillosis. Patients with a history of aspergillosis before cancer were excluded, and the secondary outcome was the risk of mortality in cancer patients with and without aspergillosis after 1 year.Results: Among 951 cancer patients with a diagnosis of aspergillosis, there were 614 hematopoietic and reticuloendothelial system patients, 100 lung cancer patients, and 73 lymphoma cancer patients. The overall incidence rates of aspergillosis tended to increase significantly from 2006 to 2017 (from 3.50 to 13.37 per 10,000 person-years, p value: < 0.0001). Regarding sex, the incidence rates of aspergillosis in males and females were 12.52 and 7.53 per 10,000 person-years, respectively. Patients with a diagnosis of aspergillosis had a 2.30-fold (95% CI: 2.14– 2.48, p value: < 0.0001) higher risk of mortality than those without aspergillosis.Conclusion: The incidence of aspergillosis was increased in cancer patients, and cancer patients with aspergillosis had a significantly higher risk of mortality than those without aspergillosis.Keywords: aspergillosis, cancer patients, Taiwan Cancer Registry, incidence rate
