title: Autoimmune disease and subsequent urological cancer.
abstract: OBJECTIVE
  We examined the subsequent risk and prognosis of urological cancer in individuals diagnosed with autoimmune disease.
  
  
  METHODS
  We systematically analyzed the risk and prognosis of prostate, kidney and bladder cancers in individuals diagnosed with any of 33 autoimmune diseases based on a national Swedish database for 1964 through 2008. The SIR and HR were calculated for subsequent urological cancers between 1964 and 2008 in individuals hospitalized for autoimmune disease.
  
  
  RESULTS
  An increased SIR for urological cancer was recorded after 26 autoimmune diseases. An increased HR for cancer specific survival was noted after 4 autoimmune diseases and for overall survival after 18. The highest SIRs were seen for kidney cancer after polyarteritis nodosa (2.85) and polymyositis/dermatomyositis (2.68), and for bladder cancer after polymyositis/dermatomyositis (2.45). The highest risk of prostate cancer (1.70) was observed after polyarteritis nodosa. SIRs were lower during followup from 1990 to 2008 compared to the previous period. Individuals diagnosed with prostate and kidney cancers showed an improved cancer specific prognosis, in contrast to the poorer overall prognosis for all 3 urological cancers.
  
  
  CONCLUSIONS
  The risk of urological cancer was increased after all autoimmune diseases. The most significant changes after individual autoimmune diseases were toward higher risk. Survival data were reassuring since autoimmune disease only marginally influences the prognosis of cancer specific mortality. However, overall survival was decreased for the 3 types of cancer.
authors.affiliation: Center for Primary Health Care Research, Lund University, Malmö, Sweden. xiangdong.liu@med.lu.se
authors.forename: Xiangdong
authors.initials: X
authors.lastname: Liu
authors.forename: Jianguang
authors.initials: J
authors.lastname: Ji
authors.forename: Asta
authors.initials: A
authors.lastname: Forsti
authors.forename: Kristina
authors.initials: K
authors.lastname: Sundquist
authors.forename: Jan
authors.initials: J
authors.lastname: Sundquist
authors.forename: Kari
authors.initials: K
authors.lastname: Hemminki
mesh_terms: D017677:Age Distribution; D017668:Age of Onset; D000368:Aged; D001327:Autoimmune Diseases / Q000175:diagnosis* / Q000453:epidemiology*; D015897:Comorbidity; D016001:Confidence Intervals; D016208:Databases, Factual; D005260:Female; D006801:Humans; D015994:Incidence; D007680:Kidney Neoplasms / Q000175:diagnosis / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D016016:Proportional Hazards Models; D011471:Prostatic Neoplasms / Q000175:diagnosis / Q000453:epidemiology; D012042:Registries; D012189:Retrospective Studies; D018570:Risk Assessment; D017678:Sex Distribution; D016019:Survival Analysis; D013548:Sweden / Q000453:epidemiology; D001749:Urinary Bladder Neoplasms / Q000175:diagnosis / Q000453:epidemiology; D014571:Urologic Neoplasms / Q000175:diagnosis* / Q000453:epidemiology*