Dr. Kim has received research support from Takeda Pharmaceuticals North America and Pfizer.
No differences in cancer screening rates in patients with rheumatoid arthritis compared to the general population
Version of Record online: 27 SEP 2012
Copyright © 2012 by the American College of Rheumatology
Arthritis & Rheumatism
Volume 64, Issue 10, pages 3076–3082, October 2012
How to Cite
Kim, S. C., Schneeweiss, S., Myers, J. A., Liu, J. and Solomon, D. H. (2012), No differences in cancer screening rates in patients with rheumatoid arthritis compared to the general population. Arthritis & Rheumatism, 64: 3076–3082. doi: 10.1002/art.34542
- Issue online: 27 SEP 2012
- Version of Record online: 27 SEP 2012
- Accepted manuscript online: 10 JUL 2012 11:19AM EST
- Manuscript Accepted: 8 MAY 2012
- Manuscript Received: 6 FEB 2012
- NIH. Grant Numbers: K23-AR-059677, K24-AR-055989, P60-AR-047782, R21-DE-018750, R01-AR-056215
- Agency for Healthcare Research and Quality
- US Food and Drug Administration
Previous study findings have suggested that patients with chronic diseases such as rheumatoid arthritis (RA) do not receive optimal preventive medical services, including cancer screening tests. This study was undertaken to evaluate cancer screening rates in RA patients compared to non-RA control populations.
Using data from a large US commercial insurance plan, we examined rates of screening tests for cervical, breast, and colon cancer in patients with RA compared to control subjects without RA (non-RA controls) or control subjects with hypertension. Individuals were included in the RA cohort if they had at least 2 visits coded for a diagnosis of RA and had received at least 1 prescription for a disease-modifying antirheumatic drug during the study period. Multivariable Cox proportional hazards models were used to compare the rates of different cancer screening tests between RA patients and non-RA controls.
RA patients (n = 13,314) and control subjects (non-RA and hypertension controls) (n = 212,324) were screened, on average, once every 3 years for cervical cancer and once every 2 years for breast cancer during the followup period (mean 2.3 years of followup). In the age-adjusted Cox regression model, women with RA were more likely to receive ≥1 Papanicolaou smear (hazard ratio [HR] 1.21, 95% confidence interval [95% CI] 1.17–1.24), ≥1 mammogram (HR 1.49, 95% CI 1.45–1.53), and ≥1 colonoscopy (HR 1.69, 95% CI 1.61–1.77) compared to female non-RA control subjects. Men with RA were also more likely to receive at least 1 colonoscopy (HR 1.52, 95% CI 1.40–1.64) than were male non-RA control subjects. These results were robust in multivariable analyses adjusted for age, number of physician visits, percentage of visits made to primary care physicians, and the Charlson Comorbidity Index.
Patients with RA did not appear to be at risk for receiving fewer cancer screening tests when compared to individuals without RA. The majority of both RA patients and non-RA control subjects were screened regularly for cervical, breast, and colon cancer, in accordance with current recommendations.