Date of Award

Fall 1-6-2017

Degree Type

Thesis

Degree Name

Master of Public Health (MPH)

Department

Public Health

First Advisor

Yeong Ruey Chu

Second Advisor

Dora Il'yasova

Third Advisor

Ruiyan Luo

Fourth Advisor

Wen Chao Ho

Abstract

Background: In a previous study, it was shown that melanoma patients have a greater incidence of glioma as compared to the general population in United States. Because glioma and melanoma do not have common environmental risk factors, this observation suggests a common genetic predisposition shared by glioma and melanoma that maybe used to lead future research of the specific genes and drug targets for both malignancies. However, this observation has to be confirmed in other populations. The aim of this study was to investigate the association between melanoma and glioma in Taiwanese population.

Methods: We used claim data of Taiwan’s National Health Insurance Research Database (NHIRD) from year 1998 to 2010. The study population included 1,000,000 randomly selected men and women ages 20 and older from the NHIRD database. Glioma was defined by ICD-9-CM codes 191, 192.0-192.3, 192.8, 192.9, 225 and 237.5. Melanoma was defined by ICD-9-CM codes 172, 173, 190.0, 190.9, 192.1, 216.X (X=0, 3-7, 9), 224, 223.2, 235.1, 235.2, 237.6, 238.2, 238.3, 238.8. We excluded participants under ages 20 at 1998 and unknown gender (n=324,879). Cox's proportional hazard regression analysis was conducted to estimate the association between the history of melanoma on glioma risk.

Main results: The hazard ratio of developing glioma was significantly higher in patients with melanoma than in those without melanoma (hazard ratio (HR) = 6.18; 95% confidence interval (CI) = 5.57-6.85). The hazard ratio for developing glioma was lower in male patients than in female patients, with the hazard ratio of 0.77 (95% CI = 0.71-0.84), adjusted for melanoma and age. The hazard ratio increased with age peaking at age group age from 60 to 69 and decrease after 70 years and older.

Conclusion: The present study showed that Taiwanese patients with melanoma are at a higher risk of developing glioma. The exact underlying etiologies require further investigation.

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