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Article History

Received: 28 February 2024

Accepted: 24 February 2025

First Online: 15 March 2025

Declarations

:

: This study was approved by the Institutional Review Board (IRB) of Tzu-Chi Medical Foundation (Approval Number: IRB109-015-B). As this study was conducted using fully de-identified, real-world big data from the National Health Insurance Research Database (NHIRD) and the Taiwan Cancer Registry Database, individual informed consent was not required. The datasets were de-identified in strict compliance with Taiwan’s Personal Information Protection Act, and no direct patient interactions or interventions were involved. Therefore, the IRB granted a waiver for informed consent. Furthermore, this study adhered to the ethical principles outlined in the Declaration of Helsinki, ensuring the protection, confidentiality, and ethical use of patient data throughout the research process. Access to the NHIRD dataset was granted through formal application and approval from the relevant regulatory authorities.

: Not applicable.

: Informed consent was waived because the data sets are covered under the Personal Information Protection Act. Szu-Yuan Wu, MD, PhD had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. The data has not been previously presented orally or by poster at scientific meetings.

: The authors declare no competing interests.