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Malignancies in Giant Cell Arteritis: A Population-based Cohort Study.

Authors
  • Stamatis, Pavlos1, 2
  • Turesson, Carl3, 4
  • Willim, Minna3, 4
  • Nilsson, Jan-Åke3, 4
  • Englund, Martin3, 4
  • Mohammad, Aladdin J3, 4
  • 1 From Lund University, Department of Clinical Sciences Lund, Section of Rheumatology, and Orthopaedics and Clinical Epidemiology Unit, Lund; Lund University, Department of Clinical Sciences Malmö, Section of Rheumatology, Malmö, Sweden; Department of Medicine, University of Cambridge, Cambridge, UK. [email protected] , (Sweden)
  • 2 P. Stamatis, MD, Consultant in Rheumatology, Department of Clinical Sciences Lund, Rheumatology, Lund University; C. Turesson, MD, PhD, Professor of Rheumatology, Senior Consultant Rheumatologist, Department of Clinical Sciences Malmö, Rheumatology, Lund University; M. Willim, IT Coordinator, Department of Clinical Sciences Lund, Rheumatology, Lund University; J.Å. Nilsson, PhD, Statistician, Department of Clinical Sciences Lund, Rheumatology, Lund University; M. Englund, MD, PhD, Professor of Epidemiology, Department of Clinical Sciences, Lund, Clinical Epidemiology Unit; A.J. Mohammad, MD, PhD, Associate Professor of Rheumatology, Senior Consultant Rheumatologist, Department of Clinical Sciences, Rheumatology, Clinical Epidemiology Unit, Lund University, and Department of Medicine, University of Cambridge. [email protected]
  • 3 From Lund University, Department of Clinical Sciences Lund, Section of Rheumatology, and Orthopaedics and Clinical Epidemiology Unit, Lund; Lund University, Department of Clinical Sciences Malmö, Section of Rheumatology, Malmö, Sweden; Department of Medicine, University of Cambridge, Cambridge, UK. , (Sweden)
  • 4 P. Stamatis, MD, Consultant in Rheumatology, Department of Clinical Sciences Lund, Rheumatology, Lund University; C. Turesson, MD, PhD, Professor of Rheumatology, Senior Consultant Rheumatologist, Department of Clinical Sciences Malmö, Rheumatology, Lund University; M. Willim, IT Coordinator, Department of Clinical Sciences Lund, Rheumatology, Lund University; J.Å. Nilsson, PhD, Statistician, Department of Clinical Sciences Lund, Rheumatology, Lund University; M. Englund, MD, PhD, Professor of Epidemiology, Department of Clinical Sciences, Lund, Clinical Epidemiology Unit; A.J. Mohammad, MD, PhD, Associate Professor of Rheumatology, Senior Consultant Rheumatologist, Department of Clinical Sciences, Rheumatology, Clinical Epidemiology Unit, Lund University, and Department of Medicine, University of Cambridge.
Type
Published Article
Journal
The Journal of rheumatology
Publication Date
Mar 01, 2020
Volume
47
Issue
3
Pages
400–406
Identifiers
DOI: 10.3899/jrheum.190236
PMID: 31154410
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

To investigate the risk of cancer in patients with biopsy-proven giant cell arteritis (GCA) from a defined population in southern Sweden. The study cohort consisted of 830 patients (mean age at GCA diagnosis was 75.3 yrs, 74% women) diagnosed with biopsy-proven GCA between 1997 and 2010. Temporal artery biopsy results were retrieved from a regional database and reviewed to ascertain GCA diagnosis. The cohort was linked to the Swedish Cancer Registry. The patients were followed from GCA diagnosis until death or December 31, 2013. Incident malignancies registered after GCA diagnosis were studied. Based on data on the first malignancy in each organ system, age- and sex-standardized incidence ratios (SIR) with 95% CI were calculated compared to the background population. One hundred seven patients (13%) were diagnosed with a total of 118 new malignancies after the onset of GCA. The overall risk for cancer after the GCA diagnosis was not increased (SIR 0.98, 95% CI 0.81-1.17). However, there was an increased risk for myeloid leukemia (2.31, 95% CI 1.06-4.39) and a reduced risk for breast cancer (0.33, 95% CI 0.12-0.72) and upper gastrointestinal tract cancer (0.16, 95% 0.004-0.91). Rates of other site-specific cancers were not different from expected. In this Swedish population-based cohort of GCA, the overall risk for cancer was not increased compared to the background population. However, there was an increased risk for leukemia and a decreased risk for breast and upper gastrointestinal tract cancer.

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