Abstract
BACKGROUND: Several case reports have recounted hiccups as a possible symptom of cancer, but potential associations in large study samples have not been examined. METHODS: This population-based cohort study examined associations between hiccups and subsequent cancer diagnoses. Standardized incidence ratios (SIRs) and 95% confidence intervals (CIs) were calculated. RESULTS: Of 8466 patients diagnosed with hiccups during the study period (1997-2018), 7531 (89.0%) were men, 4013 (47.4%) were diagnosed in primary healthcare, and 325 (3.8%) were diagnosed with cancer. In men, hiccups were associated with nervous system (SIR 1.94; 95% CI, 1.08-3.20), hematologic (1.52; 1.17-1.93), and gastrointestinal (1.61; 1.36-1.89) cancers, including esophageal (2.63; 1.47-4.43), stomach (2.27; 1.42-3.45), colon (1.61; 1.23-2.08), and liver (1.77; 1.05-2.80) cancers. In women, hiccups were associated with gastrointestinal cancer (2.23; 1.27-3.63). Particularly strong associations were observed within 12 months of follow-up. CONCLUSION: These findings may be useful for clinical practice and could provide foundations for detailed clinical studies on hiccups as a potential clinical cancer marker.