title: Risk of malignancy in ankylosing spondylitis: a systematic review and meta-analysis.
abstract: Current knowledge about the overall and site-specific risk of malignancy associated with ankylosing spondylitis (AS) is inconsistent. We conducted a systematic review and meta-analysis to address this knowledge gap. Five databases (PubMed, EMBASE, Web of Science, the Cochrane library and the virtual health library) were systematically searched. A manual search of publications within the last 2 years in key journals in the field (Annals of the Rheumatic Diseases, Rheumatology and Arthritis &rheumatology) was also performed. STATA 11.2 software was used to conduct the meta-analysis. After screening, twenty-three studies, of different designs, were eligible for meta-analysis. AS is associated with a 14% (pooled RR 1.14; 95% CI 1.03-1.25) increase in the overall risk for malignancy. Compared to controls, patients with AS are at a specific increased risk for malignancy of the digestive system (pooled RR 1.20; 95% CI 1.01 to 1.42), multiple myelomas (pooled RR 1.92; 95% CI 1.37 to 3.69) and lymphomas (pooled RR 1.32; 95% CI 1.11 to 1.57). On subgroup analysis, evidence from high quality cohort studies indicated that AS patients from Asia are at highest risk for malignancy overall. Confirmation of findings from large-scale longitudinal studies is needed to identify specific risk factors and to evaluate treatment effects.
authors.affiliation: Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences &Peking Union Medical College, Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, 1 Shuaifuyuan, Dongcheng District, 100005, Beijing, China.
authors.forename: Chuiwen
authors.initials: C
authors.lastname: Deng
authors.affiliation: Department of Rheumatology, China-Japan Friendship Hospital, Yinghua East Road, Chaoyang District, 100029, Beijing, China.
authors.forename: Wenli
authors.initials: W
authors.lastname: Li
authors.affiliation: Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences &Peking Union Medical College, Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, 1 Shuaifuyuan, Dongcheng District, 100005, Beijing, China.
authors.forename: Yunyun
authors.initials: Y
authors.lastname: Fei
authors.affiliation: Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences &Peking Union Medical College, Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, 1 Shuaifuyuan, Dongcheng District, 100005, Beijing, China.
authors.forename: Yongzhe
authors.initials: Y
authors.lastname: Li
authors.affiliation: Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences &Peking Union Medical College, Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, 1 Shuaifuyuan, Dongcheng District, 100005, Beijing, China.
authors.forename: Fengchun
authors.initials: F
authors.lastname: Zhang
mesh_terms: D016208:Databases, Factual; D004067:Digestive System Neoplasms / Q000209:etiology; D006801:Humans; D008223:Lymphoma / Q000209:etiology; D009101:Multiple Myeloma / Q000209:etiology; D009369:Neoplasms / Q000209:etiology*; D012307:Risk Factors; D013167:Spondylitis, Ankylosing / Q000150:complications / Q000473:pathology*