OCCURRENCE OF CANCER IN ALZHEIMER AND ELDERLY CONTROL PATIENTS - AN EPIDEMIOLOGIC NECROPSY STUDY

Epidemiologic necropsy provides an accurate measure of the occurrence rates of diseases. To determine the occurrence of cancer in Alzheimer patients as well as in non-Alzheimer elderly controls, we examined aut opsy reports of 575 control and 71 Alzheimer cases aged 50-100 years f or histologic evidence of cancer. We compared expected rates of cancer s calculated from the National Cancer institute's Surveillance, Epidem iology and End Result (SEER) Program data to rates observed at autopsy using a chi-squared test. To determine whether there was an associati on between the occurrence of cancer and Alzheimer disease, we compared rates for all cancer and three specific cancers in Alzheimer and cont rol patients using an odds ratio test. We found from fourfold to 98-fo ld more cancer in Alzheimer patients and controls than that expected f rom SEER data. There was no statistical difference in the autopsy inci dence of total, lung, or prostate cancer between Alzheimer patients an d controls. However, the occurrence of pancreatic cancer was 6.7-fold higher in Alzheimer patients than in control subjects. Controlling for multiple comparisons, the odds ratio for pancreatic cancer in Alzheim er's disease was significantly higher than in controls (p< 0.001). Our results indicate that cancer occurs more frequently than expected in both Alzheimer patients and control subjects. In addition, there may b e an association between the occurrence of certain cancers and Alzheim er's disease.