INCIDENCE OF CANCER AMONG PATIENTS WITH RHEUMATOID-ARTHRITIS
INCIDENCE OF CANCER AMONG PATIENTS WITH RHEUMATOID-ARTHRITIS
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DOI：
10.1093/jnci/85.4.307
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发表时间：
1993-02-17
影响因子：
10.3
通讯作者：
FRAUMENI, JF
中科院分区：
文献类型：
--
作者：
GRIDLEY, G;MCLAUGHLIN, JK;FRAUMENI, JF
背景：为了评估有关免疫改变与癌症之间关系的假设，一些研究人员确定了类风湿性关节炎（RA）（一种慢性自身免疫性疾病）患者群体的癌症发病率。主要发现是造血系统癌症的风险增加。目的：在这项研究中，我们试图完善对 RA 与特定癌症的后续发展之间关联的估计。方法：我们在一项基于人群的队列研究中调查了与 RA 相关的特定部位癌症风险，该研究纳入了 11 683 名医院（住院患者）诊断为 RA 的瑞典男性和女性。这些病例是从 1965 年到 1983 年确定的，并通过瑞典医院住院病人登记处与瑞典国家癌症登记处（840 例癌症患者）和瑞典死因登记处的计算机连接进行了随访直至 1984 年。癌症风险是通过特定癌症的标准化发病率（SIR）来估计的。结果：总体而言，对于男性和女性，患结肠癌（SIR = 0.63；95% 置信区间 [CI] = 0.5-0.9）、直肠癌（SIR = 0.72；95% CI = 0.5-1.1）和胃癌（SIR = 0.63；95% CI = 0.5-0.9）的风险降低，患淋巴瘤的风险增加（SIR = 1.98；95% CI = 1.5-2.6)。结论：RA 患者结直肠癌风险降低与之前对 RA 患者的研究以及使用非甾体类抗炎药可预防大肠癌的报告一致。淋巴瘤的增多也证实了早期对 RA 患者的一些研究。
Background: To evaluate hypotheses about the relationship between immune alterations and cancer, several investigators have determined cancer incidence in groups of patients with rheumatoid arthritis (RA), a chronic autoimmune disease. The primary finding has been an increased risk of hematopoietic cancers. Purpose: In this study, we have attempted to refine estimates of the association between RA and subsequent development of specific cancers. Methods: We investigated site-specific cancer risk associated with RA in a population-based cohort study of 11 683 Swedish men and women with a hospital (inpatient) diagnosis of RA. These case patients were identified from 1965 to 1983 and had follow-up through 1984 by computer linkage of the Swedish Hospital Inpatient Register to the National Swedish Cancer Registry (840 case patients with cancer) and the Swedish Registry of Causes of Death. Cancer risk was estimated by standardized incidence ratios (SIRs) for specific cancers. Results: For men and women overall, there were decreased risks for cancers of the colon (SIR = 0.63; 95% confidence interval [CI] = 0.5-0.9), rectum (SIR = 0.72; 95% CI = 0.5-1.1), and stomach (SIR = 0.63; 95% CI = 0.5-0.9) and an increased risk for lymphomas (SIR = 1.98; 95% CI = 1.5-2.6). Conclusions: The reduced risk for colorectal cancer in patients with RA is consistent with previous studies of RA patients and with reports which state that use of nonsteroidal anti-inflammatory drugs may protect against the development of large bowel cancers. The excess of lymphomas also confirms a number of earlier investigations of RA patients.