Occurrence of cancer* in people admitted with motor neuron disease before or after an admission for cancer: number of people in the reference cohort† with each cancer, observed and expected number of cases in the motor neuron disease or cancer cohorts, ratio of rate in the motor neuron disease or cancer cohort to that in the reference cohort and 95% CIs for the rate ratio
| Cancer after motor neuron disease | Cancer before motor neuron disease | |||||||
| Cancer (ICD code)‡ and No of cases in reference cohort (n) | Observed number | Expected number | Adjusted rate ratio (95% CIs)§ | p Value | Observed number | Expected number | Adjusted rate ratio (95% CIs)§ | p Value |
| All cancers (140–208) (n=29 196) | 62 | 63 | 0.98 (0.75 to 1.26) | 0.95 | 96 | 108.5 | 0.84 (0.66-1.07) | 0.15 |
| Larynx (161) (n=281) | 3 | 0.9 | 3.5 (0.7 to 10.2) | 0.09 | 2 | 1.9 | 1.0 (0.1 to 3.8) | 0.77 |
| Salivary gland (142) (n=105) | 2 | 0.2 | 9.5 (1.1 to 35.0) | <0.004 | 2 | 0.7 | 3.0 (0.4 to 10.8) | 0.11 |
| Stomach (151) (n=1410) | 7 | 3.7 | 1.9 (0.8 to 3.9) | 0.15 | 2 | 3.3 | 0.6 (0.1 to 2.2) | 0.66 |
| Colon (153) (n=2680) | 4 | 7.5 | 0.5 (0.2 to 1.4) | 0.28 | 10 | 10.8 | 0.9 (0.4 to 1.7) | 0.80 |
| Rectum (154) (n=1570) | 4 | 4.5 | 0.9 (0.2 to 2.3) | 1.00 | 11 | 8.6 | 1.3 (0.6 to 2.4) | 0.40 |
| Lung (162) (n=4587) | 15 | 11.4 | 1.3 (0.7 to 2.2) | 0.28 | 10 | 10.2 | 1.0 (0.5 to 1.8) | 0.94 |
| Breast (174, 175) (n=2717) | 6 | 4.6 | 1.3 (0.5 to 2.9) | 0.67 | 13 | 16.1 | 0.8 (0.4 to 1.4) | 0.43 |
| Prostate (185) (n=2448) | 0 | 6.1 | 0 (0 to 0.5) | 0.007 | 13 | 10.8 | 1.2 (0.6 to 2.2) | 0.48 |
| Bladder (188) (n=1766) | 6 | 4.7 | 1.3 (0.5 to 2.8) | 0.71 | 6 | 11.9 | 0.5 (0.2 to 1.1) | 0.08 |
| Non-melanoma skin cancer (173) (n=1957) | 4 | 4.9 | 0.8 (0.2 to 2.1) | 0.86 | 13 | 14.1 | 0.9 (0.5 to 1.6) | 0.77 |
| Malignant brain (191) (n=543) | 2 | 1.1 | 1.9 (0.2 to 6.8) | 0.70 | 5 | 0.7 | 7.4 (2.4 to 17.5)¶ | <0.001 |
| Lymphoma (200,202) (n=925) | 6 | 2.3 | 2.6 (0.9 to 5.6) | 0.06 | 2 | 3.3 | 1.3 (0.4 to 3.1) | 0.48 |
| Hodgkin's disease (201) (n=204) | 1 | 0.3 | 3.3 (0.9) | 0.72 | 3 | 0.6 | 5.3 (1.1 to 15.6)** | 0.014 |
↵* Data not shown for 16 cancers studied, with non-significant results and fewer than five observed cases in people with motor neuron disease (combining cancers before and after motor neuron disease (MND)). The cancers that were studied in addition to those shown in the tables were (with number of cases before and after MND): oral cavity and pharynx (3), nasopharynx (0), oesophagus (4), liver (0), pancreas (0), cervix (4), ovary (0), uterus (2), testis (0), kidney (2), malignant melanoma (1), other nervous system (1), thyroid (1), bone (2), leukaemia (4) and benign brain (3). Full results available on request from the authors.
↵† Conditions used in reference cohort, with Office of Population, Censuses and Surveys code edition 3 for operations and ICD9 code for diagnosis (with equivalent codes used for other coding editions): appendicectomy (441–444), hip arthroplasty (810, 811), knee arthroplasty (812), tonsillectomy (230–236), squint (378), otitis externa, otitis media (380–382), varicose veins (454), haemorrhoids (455), upper respiratory tract infections (460–466), deflected septum, nasal polyp (470–471), impacted tooth and other disorders of teeth (520–521), inguinal hernia (550), ingrowing toenail and other diseases of nail (703), sebaceous cyst (706.2), internal derangement of knee (717), bunion (727.1), selected fractures (810–816, 823–826), dislocations, sprains and strains (830–839, 840–848 and superficial injury and contusion (910–919, 920–924).
↵‡ ICD nine codes for each cancer (equivalent codes were used for cases coded in ICD revisions 7, 8 and 10).
↵§ Adjusted for sex, age in 5 year bands, time period in single calendar years and district of residence.
↵¶ Exclusion of cases of MND that occurred within a year of malignant brain tumours left no observed cases and therefore a rate ratio of 0.
↵** When excluding cases that occurred within a year, the rate ratio for MND in people with Hodgkin's lymphoma was 4.1, 0.5–15.0, based on 2 observed cases and 0.5 expected.