title: Cancer Risk in Patients With Inflammatory Systemic Autoimmune Rheumatic Diseases: A Nationwide Population-Based Dynamic Cohort Study in Taiwan.
abstract: The aim of this study was to determine whether inflammation is related to cancer development, and whether the incidence of cancer is increased and occurs in a site-specific manner in patients with systemic autoimmune rheumatic diseases (SARDs).This study included a nationwide dynamic cohort of patients with various newly diagnosed SARDs from 1997 to 2010 with follow-up until 2012.This study included 75,123 patients with SARDs. During 562,870 person-years of follow-up, 2844 patients developed cancer. Between 1997 and 2010, the highest number of newly diagnosed SARDs cases were rheumatoid arthritis (n = 35,182), followed by systemic lupus erythematosus (SLE, n = 15,623), Sjögren syndrome (n = 11,998), Kawasaki disease (n = 3469), inflammatory bowel disease (n = 2853), scleroderma (n = 1814), Behçet disease (n = 1620), dermatomyositis (n = 1119), polymyositis (n = 811), and vasculitis other than Kawasaki disease (n = 644). A significant standardized incidence ratio (SIR) of overall cancer was observed for patients with SLE (1.41; 95% confidence interval [CI], 1.28-1.56), Sjögren syndrome (1.19; 95% CI, 1.08-1.30), scleroderma (1.27; 95% CI, 1.02-1.59), dermatomyositis (4.79; 95% CI, 4.01-5.73), polymyositis (1.47; 95% CI, 1.05-2.06), vasculitis excluding Kawasaki disease (1.75; 95% CI, 1.20-2.55), and Kawasaki disease (2.88; 95% CI, 1.60-5.20). Overall, patients with most SARDs had a significantly higher risk of inflammation-associated site-specific cancers and hematologic malignancies.This study confirms that autoimmunity is associated with site-specific and hematological malignancies and provides clinical evidence of an association between inflammation and subsequent site-specific cancer development. These findings support the importance of inflammation in site-specific organ system carcinogenesis.
authors.affiliation: From the Division of Rheumatology, Allergy, and Immunology (K-HY, C-FK), Department of Internal Medicine, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine; Department of Public Health (LHH, L-CS), College of Medicine, Chang Gung University; Division of Hematology-Oncology (W-KH), Department of Internal Medicine, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine; and Biostatistics Core Laboratory (L-CS), Molecular Medicine Research Center, Chang Gung University, Taoyuan, Taiwan.
authors.forename: Kuang-Hui
authors.initials: KH
authors.lastname: Yu
authors.forename: Chang-Fu
authors.initials: CF
authors.lastname: Kuo
authors.forename: Lu Hsiang
authors.initials: LH
authors.lastname: Huang
authors.forename: Wen-Kuan
authors.initials: WK
authors.lastname: Huang
authors.forename: Lai-Chu
authors.initials: LC
authors.lastname: See
mesh_terms: D000328:Adult; D000367:Age Factors; D001172:Arthritis, Rheumatoid / Q000150:complications / Q000453:epidemiology; D001327:Autoimmune Diseases / Q000150:complications* / Q000453:epidemiology; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D015212:Inflammatory Bowel Diseases / Q000150:complications / Q000453:epidemiology; D008180:Lupus Erythematosus, Systemic / Q000150:complications / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009080:Mucocutaneous Lymph Node Syndrome / Q000150:complications / Q000453:epidemiology; D009369:Neoplasms / Q000453:epidemiology / Q000209:etiology*; D012216:Rheumatic Diseases / Q000150:complications* / Q000453:epidemiology; D012307:Risk Factors; D012859:Sjogren's Syndrome / Q000150:complications / Q000453:epidemiology; D013624:Taiwan / Q000453:epidemiology