RESEARCH - Cancer risk in hospitalized RA patients

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Rheumatology Advance Access originally published online on March 30, 2008

Rheumatology 2008 47(5):698-701; doi:10.1093/rheumatology/ken130

Cancer risk in hospitalized rheumatoid arthritis patients

K. Hemminki1,2, X. Li2, K. Sundquist2 and J. Sundquist2

1Division of Molecular Genetic Epidemiology, German Cancer Research

Center (DKFZ), Heidelberg, Germany and 2Department of Family and

Community Medicine Stockholm, Karolinska Institute, Huddinge, Sweden.

Abstract

Objectives. Patients diagnosed with RA have been at an increased risk

of many cancers and at a decreased risk of some cancers. We planned to

revisit the theme by using a nation-wide population of RA patients.

Methods. An RA research database was constructed by identifying

hospitalized RA patients from the Hospital Discharge Register and

cancer patients from the Cancer Registry. Earlier studies from Sweden

have shown that some 75% of RA patients have been hospitalized at some

time point. Follow-up of 42 262 RA patients was carried out from year

1980 to 2004 including separate follow-ups for shorter intervals.

Standardized incidence ratios (SIRs) were calculated for cancer in RA

patients by comparing with subjects without RA.

Results. Many cancers were in excess in RA patients, especially

Hodgkin disease, non-Hodgkin lymphoma and squamous cell skin cancer; a

novel association was found for non-thyroid endocrine tumours. Colon,

rectal and endometrial cancers were decreased in RA patients. When RA

patients were first hospitalized after 1999, the SIRs for melanoma,

squamous cell skin and upper aerodigestive tract cancers and for

leukaemia were increased compared with previous periods.

Conclusions. This study, the largest so far published, quantified the

increased and decreased site-specific risks of cancer in RA patients.

The recent increases in the risks of squamous cell skin and upper

aerodigestive tract cancers, melanoma and leukaemia call for

continuous vigilance and recording of changes in treatment.

http://rheumatology.oxfordjournals.org/cgi/content/abstract/47/5/698?etoc

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Not an MD