The association between the use of traditional Chinese medicine and mortality among cervical cancer patients: A large-scale retrospective cohort study

Introduction: Traditional Chinese medicine (TCM) is often used as a complementary approach in cancer treatment. The present study aimed to use a registry database to investigate the association between the use of TCM and mortality among cervical cancer (CC) patients. Methods: This nationwide population-based retrospective cohort study extracted data on CC patients diagnosed between 1996 and 2011 from the Registry for Catastrophic Illness Patients database of Taiwan. TCM users were frequency-matched with nonusers at a ratio of 1:1. Multivariable Cox proportional hazards analysis was used to measure the hazard ratio (HR) for mortality. The use of granulocyte-colony stimulating factor (GCSF) and blood transfusion in TCM users was compared with TCM nonusers. Results: A total of 12,147 TCM users and an equal number of paired non-users were identified. Analysis revealed a low mortality rate among TCM users compared with nonusers (log-rank test, p < 0.0001), with an overall adjusted HR of 0.64 (95% CI = 0.61 - 0.68, p < 0.001). Furthermore, TCM users had a 0.82-fold risk for the use of GCSF (95% CI = 0.73-0.93, p < 0.01), and a 0.74-fold risk for blood transfusion (95% CI = 0.71-0.77) compared with TCM nonusers. The most frequently prescribed TCM single herb and TCM formula were Hedyotis diffusa and Jia-wei-xiao-yao-san, respectively. Conclusions: The present study revealed that the use of TCM was negatively associated with the use of GCSF, blood transfusion, and mortality among CC patients, suggesting that TCM alleviated side effects of conventional treatment, and improved survival in CC patients.