Cancer morbidity in rheumatoid arthritis.

Prior, P; Symmons, Deborah; Hawkins, C F; Scott, David; Brown, Roger

doi:10.1136/ard.43.2.128

Cited by 145 publications

(51 citation statements)

References 10 publications

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“…Generally, the excess risk of malignant lymphomas is in accordance with earlier findings (5,6,(8)(9)(10)29,30), although previously reported risks have ranged from not elevated (31) to 20-fold increased (32). The divergent results between studies could be due to many factors, such as study size and design, but also differences in the definitions of exposure (RA) and outcome (malignant lymphoma).…”

Section: Discussionsupporting

confidence: 73%

Risk of malignant lymphomas in patients with rheumatoid arthritis and in their first‐degree relatives

Ekström¹,

Hjalgrim²,

Brandt³

et al. 2003

Arthritis & Rheumatism

250

152

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Objective. Patients with rheumatoid arthritis (RA) are at increased risk for malignant lymphomas. Both conditions display a familial aggregation, and there are reports of RA and malignant lymphomas occurring in the same families. This study was undertaken to determine the risk of malignant lymphomas in first-degree relatives of RA patients, in order to investigate whether the increased risk of malignant lymphomas in RA could be due to genetic or environmental risk factors common to both conditions, rather than being a consequence of the rheumatic disease.Methods. Using Swedish nationwide and population-based registers, we identified 76,527 patients hospitalized with RA in 1964-1999 and 70,290 firstdegree relatives of a subset of these patients. These subjects were followed up for more than 3 decades, and information on cancer occurrence was recorded.Results. Patients with RA had a significantly increased risk of malignant lymphomas (535 cases; standardized incidence ratio [SIR] 2.00, 95% confidence interval [95% CI] 1.83-2.17), which was apparent for up to 2 decades of followup. Among the first-degree relatives without RA, no increased risk of malignant lymphomas was found overall, although modest and nonsignificantly elevated risk estimates were observed in subgroups. With respect to childhood cancer (0-14 years of age), we observed an increased risk of Hodgkin's lymphoma (5 cases; SIR 3.18, 95% CI 1.03-7.42).Conclusion. Patients with RA are at a markedly, but possibly time-limited, increased risk for malignant lymphomas. There is little to suggest a prominent role for coinherited or common environmental risk factors in malignant lymphomas arising in the context of RA. Instead, lymphomas complicating RA appear to be a direct consequence of the inflammation or its treatment.

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Section: Discussionsupporting

confidence: 73%

Risk of malignant lymphomas in patients with rheumatoid arthritis and in their first‐degree relatives

Ekström¹,

Hjalgrim²,

Brandt³

et al. 2003

Arthritis & Rheumatism

250

152

View full text Add to dashboard Cite

show abstract

“…In a Spanish 9-year observational study of RA, 17% of deaths were attributed to AA amyloidosis (3). In other European studies, mortality from AA amyloidosis has been reported as much lower in comparison: 2% to 7% (4,5). These studies demonstrate varying mortality associated with AA amyloidosis.…”

mentioning

confidence: 79%

Changing epidemiology of AA amyloidosis: clinical observations over 25 years at a single national referral centre

Lane¹,

Pinney²,

Gilbertson³

et al. 2017

Amyloid

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“…Some studies have reported increased risk among patients with a history of rheumatoid arthritis, 24,83,202,[290][291][292] while others have reported relative risks below 1.0. 87,280,281,289,[293][294][295] The largest case-control studies that evaluated rheumatoid arthritis all reported nonsignificant relative risks below 1.0. 87,280,281,293 In particular, Lewis et al In an Australian cohort study, risk of multiple myeloma was significantly elevated (SIR 5 12.1, 95% CI: 2.50-35.4; 3 observed cases) among persons with AIDS.…”

Section: Immune Function and Medical Historymentioning

confidence: 99%

Multiple myeloma: A review of the epidemiologic literature

et al. 2007

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Multiple myeloma, a neoplasm of plasma cells, accounts for 15% of lymphatohematopoietic cancers (LHC) and 2% of all cancers in the US. Incidence rates increase with age, particularly after age 40, and are higher in men, particularly African American men. The etiology is unknown with no established lifestyle, occupational or environmental risk factors. Although several factors have been implicated as potentially etiologic, findings are inconsistent. We reviewed epidemiologic studies that evaluated lifestyle, dietary, occupational and environmental factors; immune function, family history and genetic factors; and the hypothesized precursor, monoclonal gammopathies of undetermined significance (MGUS). Because multiple myeloma is an uncommon disease, etiologic assessments can be difficult because of small numbers of cases in occupational cohort studies, and few subjects reporting exposure to specific agents in case-control studies. Elevated risks have been reported consistently among persons with a positive family history of LHC. A few studies have reported a relationship between obesity and multiple myeloma, and this may be a promising area of research. Factors underlying higher incidence rates of multiple myeloma in African Americans are not understood. The progression from MGUS to multiple myeloma has been reported in several studies; however, there are no established risk factors for MGUS. To improve our understanding of the causes of multiple myeloma, future research efforts should seek the causes of MGUS. More research is also needed on the genetic factors of multiple myeloma, given the strong familial clustering of the disease. ' 2007 Wiley-Liss, Inc.Key words: multiple myeloma; epidemiology Multiple myeloma is a malignancy of plasma cells that results in an overproduction of light and heavy chain monoclonal immunoglobulins. The specific immunoglobulin secreted by the malignant cell is the M-protein, named in reference to its monoclonal characteristics. It is found in the serum and/or urine of persons affected with multiple myeloma.

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Cancer morbidity in rheumatoid arthritis.

Cited by 145 publications

References 10 publications

Risk of malignant lymphomas in patients with rheumatoid arthritis and in their first‐degree relatives

Risk of malignant lymphomas in patients with rheumatoid arthritis and in their first‐degree relatives

Changing epidemiology of AA amyloidosis: clinical observations over 25 years at a single national referral centre

Multiple myeloma: A review of the epidemiologic literature

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