Incidence of malignancy in Japanese patients with rheumatoid arthritis.
To determine the incidence of malignancy and site-specific malignancies in Japanese patients with rheumatoid arthritis (RA). In a prospective large observational cohort study named IORRA, 7,566 patients with RA were enrolled from April 2001 to April 2005 and were followed up to October 2005. Occurrence of malignancy was originally collected by patient reports of IORRA survey biannually from April 2001 to October 2005, and was confirmed by medical records. Standardized incidence rate (SIR) of the observed-to-expected cancer incidence and 95% confidence intervals (95% CI) were then calculated. Factors obtained at first enrollment in IORRA were assessed for association with risk of malignancy using the Cox proportional hazards model. A total of 177 malignancies in 173 patients (58 in men, 115 in women) were identified during the observation period of 25,567 person-years. The age- and sex-standardized incidence rate of malignancy was 437.1 (men, 706.8; women, 366.1) per 100,000 person-years. The SIR of malignancy was slightly excess (SIR 1.18, [95% CI 1.02-1.37]) in all patients, but 1.29 (95% CI 0.99-1.67) in men, and 1.13 (95% CI 0.94-1.36) in women. A significant excess of lymphoma (SIR 6.07, [95% CI 3.71-9.37]) and lung cancer (SIR 2.29, [95% CI 1.57-3.21]), whereas decreased incidence of colorectal cancer (SIR 0.49, [95% CI 0.26-0.83]), were found. Male gender and older age were identified as risk factors for malignancy. A slight excess in the incidence of overall malignancy and highly excess of lymphoma in Japanese RA patients was demonstrated.
Yamada
Toru
T
Institute of Rheumatology, Tokyo Women's Medical University, 10-22 Kawada-cho, Shinjuku-ku, Tokyo 162-0054, Japan. tyamada@ior.twmu.ac.jp
Nakajima
Ayako
A
Inoue
Eisuke
E
Tanaka
Eiichi
E
Taniguchi
Atsuo
A
Momohara
Shigeki
S
Yamanaka
Hisashi
H
D001172:Arthritis, Rheumatoid / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D015897:Comorbidity; D005260:Female; D006304:Health Status; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000453:epidemiology*; D010146:Pain / Q000503:physiopathology; D016016:Proportional Hazards Models; D011446:Prospective Studies
Ann Rheum Dis. 2006 Dec;65(12):1661-3
16837491
Arthritis Rheum. 2003 Dec 15;49(6):784-8
14673964
Rheumatology (Oxford). 2007 Feb;46(2):350-7
16908509
Arthritis Rheum. 2006 Mar;54(3):692-701
16508929
Semin Arthritis Rheum. 2008 Jun;37(6):388-97
17977580
Arthritis Rheum. 2006 Sep;54(9):2757-64
16947774
Med Oncol. 2009;26(1):1-9
18461290
Ann Rheum Dis. 1984 Apr;43(2):128-31
6712287
Arthritis Rheum. 2005 Mar;52(3):722-32
15751097
Scand J Rheumatol. 2010;39(5):360-7
20476859
Arthritis Rheum. 2007 May;56(5):1433-9
17469100
Ann Rheum Dis. 2005 Oct;64(10):1414-20
15843454
Int J Cancer. 2000 Nov 1;88(3):497-502
11054684
Mod Rheumatol. 2006;16(3):151-7
16767553
Ann Rheum Dis. 2005 May;64(5):699-703
15695534
J Rheumatol. 1997 Mar;24(3):445-51
9058647
Jpn J Clin Oncol. 2008 Sep;38(9):641-8
18708647
Int J Cancer. 2004 Jan 20;108(3):443-9
14648712
J Rheumatol. 2002 Jan;29(1):62-7
11824973
J Rheumatol. 1992 Sep;19(9):1462-5
1433017
Am J Hematol. 2007 Dec;82(12):1106-9
17654684
Mod Rheumatol. 2007;17(4):283-9
17694260
Semin Arthritis Rheum. 1999 Dec;29(3):148-58
10622679
J Rheumatol. 2007 Feb;34(2):322-31
17117491
Semin Arthritis Rheum. 1997 Jun;26(6):794-804
9213378
Arthritis Rheum. 1996 Feb;39(2):325-9
8849387
Pathol Res Pract. 2006;202(9):679-85
16859835
Arthritis Rheum. 2007 Mar;56(3):790-8
17328051
Arthritis Rheum. 1997 Sep;40(9):1580-6
9324011
Lung Cancer. 2008 Feb;59(2):266-9
17673329
Clin Rheumatol. 2006 Jul;25(4):498-505
16267602
Mod Rheumatol. 2008;18(2):165-9
18317879
J Rheumatol. 2008 Mar;35(3):387-93
18260176
Eur J Cancer. 1996 Sep;32A(10):1753-7
8983286
Semin Arthritis Rheum. 2007 Aug;37(1):31-8
17360028
Arthritis Res Ther. 2008;10(2):R45
18433475