Persistent Chronic Inflammation Contributes to the Development of Cancer in Patients with Rheumatoid Arthritis from a Defined Population of Northwestern Spain
Section snippets
Patients
Consecutive unselected patients who fulfilled the 1987 American College of Rheumatology (ACR) classification criteria for RA (21) seen at the rheumatology outpatient clinic of Hospital Xeral-Calde, Lugo (Northwestern Spain) between March and September 1996 were included in this study. This hospital is the single referral center for cancer and rheumatic diseases for a well-defined, stable, and ethnically homogenous, mixed rural and urban, white population living in central Galicia in
Results
One hundred eighty-two patients with RA were followed for 2447 person-years; mean follow-up from disease diagnosis was 13.4 years (median, 14 years, interquartile range [IQ range]: 10 to 16, range: 4 to 28). No patient was lost to follow-up. Most epidemiological and clinical data of this cohort of RA patients have recently been described (20). The mean age at disease onset (median [IQ range]) was 49.3 (50 [39 to 59]) years; the mean age at disease diagnosis was 54.1 (57 [46 to 64]) years, and
Discussion
In the Lugo region of Northwestern Spain the present study disclosed no increased cancer mortality in RA patients as compared with cancer mortality reported in the general population of Spain. Association between cancer and RA has been well documented in case reports, series reports, and epidemiological studies (1, 3, 5, 9, 30). Increased occurrence of malignancies such as Hodgkin’s, non-Hodgkin’s lymphoma, or multiple myeloma has been described in several cohort studies (4, 31, 32, 33, 34, 35,
References (52)
- et al.
Rheumatoid arthritis and cancer studies based on linking nationwide registries in Finland
Am J Med
(1985) - et al.
The HLA-DRB1 influence in the susceptibility and severity to rheumatoid arthritis
Semin Arthritis Rheum
(2002) - et al.
Endothelial dysfunction in rheumatoid arthritis: influence of HLA-DRB1 alleles
Autoimmun Rev
(2004) - et al.
HLA-DRB1 status affects endothelial function in treated patients with rheumatoid arthritis
Am J Med
(2003) - et al.
Excess risk of lymphomas, leukemia and myeloma in patients with rheumatoid arthritis
J Chronic Dis
(1978) - et al.
Occurrence of malignant neoplasms in the Rochester, Minnesota, rheumatoid arthritis cohort
Am J Med
(1985) - et al.
Record linkage to conduct an epidemiologic study on the association of rheumatoid arthritis and lymphoma in the Province of Saskatchewan, Canada
J Clin Epidemiol
(1993) - et al.
Cancer in rheumatoid arthritis: a prospective long-term study of mortality
Am J Med
(1985) - et al.
Rheumatoid arthritis: a disease associated with accelerated atherogenesis
Semin Arthritis Rheum
(2005) - et al.
Hematologic malignancies and the use of methotrexate in rheumatoid arthritis: a retrospective study
Am J Med
(1995)
Cancer and autoimmunity: autoimmune and rheumatic features in patients with malignancies
Ann Rheum Dis
Haematopoietic malignancies in rheumatoid arthritis: lymphoma risk and characteristics after exposure to tumour necrosis factor antagonists
Ann Rheum Dis
Risk of malignant lymphomas in patients with rheumatoid arthritis and in their first-degree relatives
Arthritis Rheum
Incidence of lymphoma in a large primary care derived cohort of cases of inflammatory polyarthritisIncidence of lymphoma in a large primary care derived cohort of cases of inflammatory polyarthritis
Ann Rheum Dis
Autoimmune and chronic inflammatory disorders and risk of non-Hodgkin lymphoma by subtype
J Natl Cancer Inst
The risk of lymphoma development in autoimmune diseases: a meta-analysis
Arch Intern Med
Autoimmune disease is a risk factor for the development of non-Hodgkin’s lymphoma
J Rheumatol
Association of chronic inflammation, not its treatment, with increased lymphoma risk in rheumatoid arthritis
Arthritis Rheum
The occurrence of malignancies in patients with rheumatoid arthritis treated with cyclophosphamide: a controlled retrospective follow-up
Ann Rheum Dis
Effects of cyclophosphamide on the development of malignancy and on long-term survival of patients with rheumatoid arthritisA 20-year follow-up study
Arthritis Rheum
The shared epitope hypothesis: an approach to understanding the molecular genetics of susceptibility to rheumatoid arthritis
Arthritis Rheum
HLA antigen associations with extra-articular rheumatoid arthritis
Tissue Antigens
Role of HLA-DR-DR and DR-DQ associations in the expression of extraarticular manifestations and rheumatoid factor in rheumatoid arthritis
J Rheumatol
Extraarticular manifestations of rheumatoid arthritis and HLA antigens in Northern Italy
J Rheumatol
Homozygosity for the HLA-DRB1 allele selects for extraarticular manifestations in rheumatoid arthritis
J Clin Invest
HLA-DRB1 and persistent chronic inflammation contribute to cardiovascular events and cardiovascular mortality in patients with rheumatoid arthritis
Arthritis Rheum
Cited by (0)
- 1
Drs. Gonzalez-Gay and Llorca share senior authorship in this study.