title: Incidence of malignancies in patients with juvenile idiopathic arthritis: A retrospective single-center cohort study in Germany.
abstract: OBJECTIVE
  In recent years, concern has been raised about Juvenile Idiopathic Arthritis (JIA) that it could be associated with an increased risk for malignancies. Therefore, the cancer incidence in the JIA patients was evaluated and compared to the cancer incidence in the German population.
  
  
  METHODS
  A retrospective single-center hospital-based cohort study was performed using data on the JIA patients treated between 1952 and 2010 at the German Center for Pediatric and Adolescent Rheumatology (GCPAR) (Garmisch-Partenkirchen, Germany). Self-administered standardized questionnaires were sent out in 2012. Standardized incidence ratios (SIRs) and their corresponding 95% confidence intervals (95%CIs) were calculated.
  
  
  RESULTS
  The study cohort consisted of 3691 JIA patients, and the response rate was 66%. Patients age ranged from 3 to 73 years of which 64% were female. Total follow-up time was 60,075 person-years; a history of malignancy was reported by 47 patients. Most common types of cancer were melanoma (n = 11), cervical cancer (n = 8) and breast cancer (n = 7). The overall SIR for women was 1.19 (95%CI: 0.77; 1.60) and for men was 0.67 (95%CI: 0.27; 1.07). The SIR for melanoma was 3.21 (95%CI: 1.60; 5.73) in women, whereas in men no melanoma cases were observed.
  
  
  CONCLUSIONS
  Although no overall increased cancer risk was found, results suggest that the risk of melanoma might be increased in female JIA patients.
authors.affiliation: a Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine , University Hospital of Munich (LMU) , Munich , Germany.
authors.forename: Swaantje
authors.initials: S
authors.lastname: Barth
authors.affiliation: a Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine , University Hospital of Munich (LMU) , Munich , Germany.
authors.forename: Jenny
authors.initials: J
authors.lastname: Schlichtiger
authors.affiliation: a Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine , University Hospital of Munich (LMU) , Munich , Germany.
authors.forename: Barbara
authors.initials: B
authors.lastname: Hartmann
authors.affiliation: a Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine , University Hospital of Munich (LMU) , Munich , Germany.
authors.forename: Betty
authors.initials: B
authors.lastname: Bisdorff
authors.affiliation: b German Center for Pediatric and Adolescent Rheumatology , Garmisch-Partenkirchen , Germany , and.
authors.forename: Hartmut
authors.initials: H
authors.lastname: Michels
authors.affiliation: a Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine , University Hospital of Munich (LMU) , Munich , Germany.
authors.forename: Katja
authors.initials: K
authors.lastname: Radon
authors.affiliation: b German Center for Pediatric and Adolescent Rheumatology , Garmisch-Partenkirchen , Germany , and.
authors.forename: Boris
authors.initials: B
authors.lastname: Hügle
authors.affiliation: c Medical Physics Group, Institute of Physics, Science Faculty , University of Zürich , Zürich , Switzerland.
authors.forename: Linda
authors.initials: L
authors.lastname: Walsh
authors.affiliation: b German Center for Pediatric and Adolescent Rheumatology , Garmisch-Partenkirchen , Germany , and.
authors.forename: Johannes-Peter
authors.initials: JP
authors.lastname: Haas
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001171:Arthritis, Juvenile / Q000453:epidemiology; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008297:Male; D009369:Neoplasms / Q000145:classification / Q000453:epidemiology; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors; D011795:Surveys and Questionnaires
keywords: Cancer; Incidence; Juvenile idiopathic arthritis (JIA); Malignancy; Melanoma; Rheumatology