Drs. Chen and Chang contributed equally to this work.
The risk of cancer in patients with rheumatoid arthritis: A nationwide cohort study in Taiwan†
Version of Record online: 28 JAN 2011
Copyright © 2011 by the American College of Rheumatology
Arthritis & Rheumatism
Volume 63, Issue 2, pages 352–358, February 2011
How to Cite
Chen, Y.-J., Chang, Y.-T., Wang, C.-B. and Wu, C.-Y. (2011), The risk of cancer in patients with rheumatoid arthritis: A nationwide cohort study in Taiwan. Arthritis & Rheumatism, 63: 352–358. doi: 10.1002/art.30134
This study is based in part on data from the National Health Insurance Research Database provided by the Bureau of National Health Insurance, Department of Health and managed by the National Health Research Institute of Taiwan. The interpretations and conclusions contained herein do not represent those of the Bureau of National Health Insurance, Department of Health, or the National Health Research Institute.
- Issue online: 28 JAN 2011
- Version of Record online: 28 JAN 2011
- Accepted manuscript online: 4 NOV 2010 01:01PM EST
- Manuscript Accepted: 28 OCT 2010
- Manuscript Received: 29 JUN 2010
- Taichung Veterans General Hospital
The association of rheumatoid arthritis (RA) and malignancy has rarely been explored in Asian populations. The aim of this study was to investigate the relative risk of cancer in Taiwanese patients with RA and to identify groups of patients with a high risk of cancer.
We conducted a nationwide cohort study of the risk of cancer among 23,644 patients with RA who had no history of malignancies, using the National Health Insurance database of Taiwan from 1996 to 2007. Standardized incidence ratios (SIRs) for various cancers were analyzed.
Among the patients with RA, 935 cancers were observed. Patients with RA had an increased risk of cancer (SIR 1.23, 95% confidence interval [95% CI] 1.22–1.23), especially hematologic cancers (SIR 2.74, 95% CI 2.68–2.81). The relative risk of cancer was higher among younger patients. Most cancer cases were detected within the first year following the diagnosis of RA. The relative risk of cancer decreased as the duration of observation increased. Among hematologic cancers, the risk of non-Hodgkin's lymphoma was greatest (SIR 3.54, 95% CI 3.45–3.63). Among solid tumors, the risk of cancers of the kidney and vagina/vulva was highest. A decreased risk of cancers of the cervix and nonmelanoma skin cancer in patients with RA was also observed.
Patients with RA have an increased risk of cancer, especially hematologic and kidney cancers. The relative risk of cancer in patients with RA decreased with long-term followup. Cancer screening with continued vigilance is recommended for patients with RA.