EpidemiologyCancer in Rheumatoid Arthritis: Occurrence, Mortality, and Associated Factors in a South European Population
Section snippets
Patients
The EMECAR cohort (Estudio de la Morbilidad y Expresión Clínica de la Artritis Reumatoide) was designed to assess the burden of comorbidity and inflammatory activity in RA and has been described in detail elsewhere (28). In summary, the cohort comprises a random sample of patients fulfilling the American College of Rheumatology classification criteria for RA, selected from the administrative databases of 34 centers. Patients who had been selected but who could not be contacted were substituted
Characteristics of the Study Population
The study started in March 1999 and ended in June 2005; the total follow-up was 2269 person-years, and the median per-patient follow-up was 3.95 years (25th to 75th percentiles (P25-75): 2.1-4.1 years) with a maximum of 6.04 years. Patient demographic and clinical baseline characteristics of the cohort, including medication use, are summarized in Table 1. The sample was composed mainly of women in their sixties (median: 64 (P25-75: 54-71)) with longstanding RA, as the mean disease duration was
Discussion
In this representative cohort of Spanish RA patients, we have not demonstrated an increase in overall cancer incidence compared with the expected rate of cancer in the general population of the same age and sex. However, we confirm an excess in lung cancer and hematological malignancies with RA.
Certain types of cancer are more frequent in some geographic areas, and survival differs from country to country (17, 18, 19, 20). This may be due to a different distribution of known and unknown risk
Acknowledgments
The authors express their acknowledgment of the outstanding logistics directed by Raquel Ruiz and by the thoughtfully supervising and data entry of Jesús Maese.
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Cited by (80)
Cancer risk with biologic and targeted synthetic DMARDs in patients with rheumatic diseases and previous malignancies: Results from the BIOBADASER register
2024, Seminars in Arthritis and RheumatismRheumatoid arthritis and risk of lung cancer: Meta-analysis and Mendelian randomization study
2021, Seminars in Arthritis and RheumatismCitation Excerpt :All statistical analyses were performed using R version 4.0.2 and package TwoSampleMR version 0.5.4 [34]. In our meta-analysis, 13 population-level cohort studies were enrolled [8–15,18–20], involving 185,773 patients with RA (137,217 females and 48,556 males). The follow-up period ranged from 2,269 person-years to 271,144 person-years or from 10 years to 18 years.
The epidemiology of established rheumatoid arthritis
2019, Best Practice and Research: Clinical RheumatologyCitation Excerpt :When compared to non-RA populations, the only cancers in excess are, as mentioned, hematological malignancies, and perhaps nonmelanoma skin cancer and lung cancer [48]. Cancer in RA may affect the assessment of disease, by increasing fatigue, depression, and acute phase reactants, all of which can be mistakenly interpreted as a flare [48]. This may lead to an inappropriate increase of immunosuppressant medication and trigger an unwanted event; a phenomenon that may underlie the observed increase in the rate of cancer very close to the initiation of biological therapies [50].
Myeloid disorders after autoimmune disease
2019, Best Practice and Research: Clinical Haematology
The EMECAR study was funded by the Spanish Society of Rheumatology, by the Spanish Foundation of Rheumatology, and by an independent research grant from Aventis, formerly from Hoechst Marion Roussel.