Cancer risk in hospitalized rheumatoid arthritis patients

Hemminki, Kari; Li, Xinjun; Sundquist, K.; Sundquist, Jan

doi:10.1093/rheumatology/ken130

Cited by 95 publications

(79 citation statements)

References 19 publications

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“…These tumors have been in large excess in rheumatoid arthritis patients according to one of our recent studies. 26 Nonmelanoma skin cancer was in excess in a previous study on UC patients. 9 …”

Section: Discussionmentioning

confidence: 91%

Cancer risks in ulcerative colitis patients

Hemminki

Sundquist

et al. 2008

Intl Journal of Cancer

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Patients diagnosed with ulcerative colitis (UC) are known to be at an increased risk of colorectal and liver cancers and leukemia. UC is an autoimmune disease, which may present a wider spectrum of cancers. We wanted to examine the risk of cancer in a large population of UC patients in order to reach high statistical power. A UC research database was constructed by identifying UC patients from the Swedish Hospital Discharge Register and cancer patients from the Cancer Registry. Follow-up of 27,606 UC patients hospitalized for the first time during the years 1964-2004 identified 2,058 patients with cancer. Standardized incidence ratios were calculated for cancer in UC patients by comparing to subjects without hospitalization for UC. The novel tumor sites in UC patients included small intestinal (carcinoid), pancreatic, breast and prostate cancers, nonthyroid endocrine gland tumors, non-Hodgkin lymphoma and multiple myeloma. A total of 11 sites showed an increased risk, which remained at 6 sites when tumors diagnosed in the year of UC hospitalization were excluded; even chronic myeloid leukemia was in excess. Cancer risks depended on the age at first hospitalization for UC. The SIRs for colon, rectal, liver and pancreatic cancers declined by age at hospitalization for UC, while for endocrine tumors the older patients were at higher risk. Our large study identified novel subsequent cancers in UC patients. However, some of these, including small intestinal carcinoids, prostate cancers and nonthyroid endocrine tumors, may be in excess because of intensified medical surveillance of the patients.

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Section: Discussionmentioning

confidence: 91%

Cancer risks in ulcerative colitis patients

Hemminki

Sundquist

et al. 2008

Intl Journal of Cancer

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“…This cancer is one of the hallmarks of dysregulated immunity; another hallmark, non-Hodgkin's lymphoma, showed no increase and a decrease in those hospitalised only once. The decrease in endometrial cancer raised the possibility that dysregulated immune function among asthma patients may affect oestrogen production (Ahmed et al, 1999;Hemminki et al, 2008). The only other tumour with a decreased risk was melanoma, but only in asthmatics diagnosed in the 1970s.…”

Section: Discussionmentioning

confidence: 99%

Cancer risk in hospitalised asthma patients

Shu

et al. 2009

Br J Cancer

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Asthma is an increasingly common disorder, affecting 5 -10% of the population. It involves a dysregulated immune function, which may predispose to subsequent cancer. We examined cancer risk among Swedish subjects who had hospital admission once or multiple times for asthma. An asthma research database was created by identifying asthma patients from the Swedish Hospital Discharge Register and by linking them with the Cancer Registry. A total of 140 425 patients were hospitalised for asthma during 1965 -2004, of whom 7421 patients developed cancer, giving an overall standardised incidence ratio (SIR) of 1.36. A significant increase was noted for most sites, with the exception of breast and ovarian cancers and non-Hodgkin's lymphoma and myeloma. Patients with multiple hospital admissions showed a high risk, particularly for stomach (SIR 1.70) and colon (SIR 1.99) cancers. A significant decrease was noted for endometrial cancer and skin melanoma. Oesophageal and lung cancers showed high risks throughout the study period, whereas stomach cancer increased towards the end of the period. The relatively stable temporal trends suggest that the asthmatic condition rather than its medication is responsible for the observed associations.

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“…AML was also seen more during the first year after diagnosis with a standardized incidence ratio (SIR) of 4.88 for less than one year and 2.03 for 1-4 years. 38 The fourth study analyzed the potential associations between individual DMARDs and the risk of developing hematologic neoplasms. This was a cohort of elderly patients (mean age 61.7 years) linked to the population data base of Quebec.…”

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confidence: 99%