Risks of solid cancers in elderly persons with osteoarthritis or ankylosing spondylitis

Abstract Objectives Patients with osteoarthritis and ankylosing spondylitis have lower cancer-related mortality than the general population. We examined risks of solid cancers at 16 sites in elderly patients with knee or hip osteoarthritis (KHOA) or ankylosing spondylitis. Methods In this population-based retrospective cohort study, we used US Medicare data from 1999 to 2010 to identify cohorts of persons with KHOA or ankylosing spondylitis, and a general population group without either condition, who were followed through 2015. We compared cancer incidence among groups, adjusted for age, sex, race, socioeconomic characteristics, geographic region, smoking and comorbidities. Results We studied 2 701 782 beneficiaries with KHOA, 13 044 beneficiaries with ankylosing spondylitis, and 10 859 304 beneficiaries in the general population group. Beneficiaries with KHOA had lower risks of cancer of the oropharynx, oesophagus, stomach, colon/rectum, hepatobiliary tract, pancreas, larynx, lung, and ovary than the general population. However, beneficiaries with KHOA had higher risks of melanoma, renal cell cancer, and cancer of the bladder, breast, uterus and prostate. Associations were similar in ankylosing spondylitis, with lower risks of cancer of the oesophagus, stomach, and lung, and higher risks of melanoma, renal cell cancer, and cancer of the renal pelvis/ureter, bladder, breast, and prostate. Conclusion Lower risks of highly prevalent cancers, including colorectal and lung cancer, may explain lower cancer-related mortality in patients with KHOA or ankylosing spondylitis. Similarities in cancer risks between KHOA and AS implicate a common risk factor, possibly chronic NSAID use.

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The impact of extracorporal circulation on therapy-related mortality and long-term survival of patients with renal cell cancer and intracaval neoplastic extension

World Journal of Urology ◽

10.1007/s00345-002-0286-z ◽

2002 ◽

Vol 20 (4) ◽

pp. 227-231 ◽

Cited By ~ 12

Author(s):

Markus A. Kuczyk ◽

Torsten Münch ◽

Stefan Machtens ◽

Volker Grünewald ◽

Udo Jonas

Keyword(s):

Renal Cell Cancer ◽

Renal Cell ◽

Cell Cancer ◽

Term Survival ◽

Extracorporal Circulation ◽

Long Term Survival ◽

The Impact ◽

Related Mortality

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Risk of renal cell cancer in people immunodepressed after solid organ transplant: Results from an Italian multicenter cohort study.

Journal of Clinical Oncology ◽

10.1200/jco.2014.32.4_suppl.422 ◽

2014 ◽

Vol 32 (4_suppl) ◽

pp. 422-422

Author(s):

Pierluca Piselli ◽

Ghil Busnach ◽

Franco Citterio ◽

Patrizia Burra ◽

Giuseppe Maria Ettorre ◽

...

Keyword(s):

Risk Factors ◽

Cohort Study ◽

General Population ◽

Renal Cell Cancer ◽

Renal Cell ◽

Cell Cancer ◽

Solid Organ ◽

Native Kidney ◽

Increased Risk ◽

Risk Of Cancer

422 Background: The etiology of renal cell cancer (RCC) is poorly understood, and data from immunosuppressed population may help to highlights risk factors unknown in the immune competent population. To assess incidence and risk factors for renal cell cancer (RCC) after kidney and liver transplant (KT and LT, respectively), we carried out a cohort investigation in 24 Italian transplant centers. Methods: This study is part of an ongoing cohort investigation conducted in 24 transplant centers in all of Italy. Two cohorts have been implemented, including 7,217 KT recipients (64.2% men) and 2,770 LT recipients (74.7% men) transplanted between 1997 and 2009—and followed-up until 2010. Person years (PY) at risk of cancer were computed from 30 days after transplant to cancer diagnosis, death, return to dialysis (for KT) or to study closure. The number of observed cancers was compared to that expected in the general population through standardized incidence ratios (SIR) and 95% confidence intervals (CI). To identify risk factors, incidence rate ratios (IRR) were computed through Poisson regression. Results: Overall, 581 cancers were diagnosed during 61,817 PYs of follow-up, with Kaposi’s sarcoma, non-Hodgkin lymphoma, lung, RCC, and prostate as the most common types. Thirty-eight cases of RCC were diagnosed (36 in KT and 2 in LT). As compared to the general population, the risk of RCC was 4.9-fold significantly higher in KT recipients than expected (95% CI: 3.4-6.8). The increased risk was restricted to the native kidney (31 native kidney OR=4.2, 95% CI:2.9-6.0), and no risk elevation was found in LT recipients (SIR=0.5 95% CI: 0.1-1.9). Use of mTOR inhibitors seemed to exert a 40% reduced risk (IRR=0.6, 95% CI: 0.2–1.4) of RCC, but the difference was not statistically significant. Conclusions: Our study findings confirmed, in Italy, the increased risks for RCC following KT, and they also suggested a possible protective effect of mTORi. The magnitude of the excess risk documented in this cohort study was higher than reported for potential risk factors described in immune competent people—or in people under dialysis—thus suggesting a role for the immune system in the etiology of RCC.

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