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Patients with RA may be at greater risk for developing lung cancer, lymphoma
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Patients with rheumatoid arthritis may have a higher risk for developing lung cancer or lymphoma compared with the general population but may be at lower risk for certain other malignancies, according to the results of a meta-analysis.
Researchers identified 136 studies that included rheumatoid arthritis (RA) and a variety of terminology related to malignancies. Inclusion criteria were studies that involved an observational design, malignancy outcomes in patients with RA and included only patients over 18 years of age.
The studies evaluated data from 458 to 84,475 patients with a mean follow-up time of 4 years to 25 years. Seven studies included the relative risk of overall malignancy, eight included the overall risk for lymphoma, lung, colorectal and breast cancer and melanoma, seven studies covered the risk of prostate cancer and four included the overall risk for cervical cancer. Eight studies reported the overall risk by type of malignancy and three reported the overall risk by sex.
The authors wrote that the overall risk for cancer remained in agreement with older studies and that patients with RA had about a 10% great risk for a malignancy.
The standardized incidence risk (SIR) for lymphoma in patients with RA ranged between 1.75 and 12.82, with a pooled SIR for Hodgkin’s lymphoma that was higher than for non-Hodgkin’s lymphoma. The pooled SIR was 2.08.
The eight studies that included lung cancer showed an increased risk to patients with RA of 1.36 to 2.9, with a pooled SIR of 1.64.
A decreased risk for colorectal cancer was reported in seven studies, with a range of a SIR of 0.49 to 1.53, with a pooled SIR of 0..
The pooled, estimated risk for breast cancer was also lower, with a SIR of 0., with study results ranging from 0.63 to 1.21.
Of 17 studies regarding melanoma and patients with RA, a range of SIRs from 0.3 to 8.83 were revealed, while five of those studies reported a range of SIR from 1.29 to 3. The pooled SIR was 1.23.
The pooled SIR for cervical cancer from 13 sources was 0.87 and a range of 0.43 to 2.15 was observed. Fifteen studies reported data related to prostate cancer and a range of SIRs from 0.35 to 3.2 was observed, with a pooled SIR of 1.15. – by Shirley Pulawski
Disclosure: Simon reports she is employee and stockholder of Bristol-Myers Squibb. Please see the full study for a list of all other authors’ relevant financial disclosures.
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