1. Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
2. Department of Family Medicine, Taichung Hospital, Ministry of Health and Welfare, Taichung, Taiwan
3. School of Medicine, Chung Shan Medical University, Taichung, Taiwan
4. Department of Obstetrics and Gynecology, Chung Shan Medical University Hospital, Taichung, Taiwan
5. Department of Obstetrics and Gynecology, Chiayi Chang Gung Memorial Hospital Chiayi, Taiwan
6. Department of Nursing, Chang Gung University of Science and Technology, Chiayi Campus, Chiayi, Taiwan
7. Department of Medical Research, Chung Shan Medical University Hospital, Taichung, Taiwan
8. Department of Obstetrics and Gynecology, Changhua Christian Hospital, Changhua, Taiwan
*These authors contributed equally to the work.
Purpose: The aim of the study was to determine the association between pelvic inflammatory disease (PID) and breast, colorectal, gynecologic and urinary tract cancer.
Methods: The source of data was a longitudinal dataset compiled by the Longitudinal Health Insurance Database 2000 (LHID2000) which was collected by the National Health Insurance program. Cases of PID, at least two outpatient visits and one admission, were diagnosed from 2000 to 2013. The data for controls, age matched women who were not diagnosed with PID from 2000 to 2013, were also obtained.
Results: A total of 47,333 PID cases and 189,332 for control group were included in the study. The ectopic pregnancy incidence rate (per 10000 person months) was 1.912 and 0.595 in the PID and control group, respectively; the rate ratio was 3.211 (confidence interval, CI = 2.931-3.519). There were significantly different in gynecologic cancers and urinary tract cancers between the PID and control group; the rate ratios (95% C.I.) were 1.903 (1.672-2.166) and 1.566 (1.211-2.025), respectively.
Conclusion: Our study found that PID was associated with increased risks of gynecologic and urinary tract cancer but not colorectal or breast cancer. The information may lead to a strategy for cancer prevention and a reasonable healthcare usage through understanding PID epidemiology and controlling the inflammatory responses.
Keywords: breast, colorectal, gynecologic, urinary tract cancer, pelvic inflammatory disease