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Increased cancer risks among arthroplasty patients: 30year follow-up of the Swedish Knee Arthroplasty Register.

Wagner, Philippe LU ; Olsson, Håkan LU ; Lidgren, Lars LU ; Robertsson, Otto LU and Ranstam, Jonas LU (2011) In European Journal of Cancer 47(7). p.1061-1071
Abstract
BACKGROUND: An increasing number of young patients are undergoing knee arthroplasties. Thus, the long-term risks of having a knee prosthesis must be evaluated. This study focuses on the potential carcinogenic effects of the prosthesis; it is a long-term follow-up of all patients in Sweden between 1975 and 2006. METHODS: The incidence of cancer in a total population of operated individuals was compared to the overall national cancer incidence in Sweden by means of standardised incidence ratios. Analysis of cancer latency period was performed to identify potential aetiological factors. RESULTS: For male and female patients with rheumatoid arthritis (RA) or osteoarthritis (OA), the overall cancer risks were elevated, ranging from 1.10 (95%... (More)
BACKGROUND: An increasing number of young patients are undergoing knee arthroplasties. Thus, the long-term risks of having a knee prosthesis must be evaluated. This study focuses on the potential carcinogenic effects of the prosthesis; it is a long-term follow-up of all patients in Sweden between 1975 and 2006. METHODS: The incidence of cancer in a total population of operated individuals was compared to the overall national cancer incidence in Sweden by means of standardised incidence ratios. Analysis of cancer latency period was performed to identify potential aetiological factors. RESULTS: For male and female patients with rheumatoid arthritis (RA) or osteoarthritis (OA), the overall cancer risks were elevated, ranging from 1.10 (95% confidence interval (CI): 1.03-1.18) for men with OA to 1.26 (1.23-1.29) for men with RA. The greatest increases in risk were observed for the leukaemia subtypes, myelodysplastic syndromes (MDS) and essential thrombocytosis (ET), ranging from 3.31 (1.24-8.83) for ET in men with OA to 7.38 (1.85-29.51) for ET in women with RA. Increases in risk were also observed for breast cancer, prostate cancer and melanoma. The latency analysis revealed elevated risks late in the study period for both solid and haematopoietic cancers. However, only increases in MDS and possibly prostate cancer and melanoma rates appeared to be connected to the operation. CONCLUSION: This study showed that OA and RA arthroplasty patients have a significantly higher risk of cancer than the general population. Elevated risks of MDS and possibly prostate cancer and melanoma indicated a potential connection to exposure to metals in the implant. The observed excessive incidence of ET was likely associated with the inflammatory disease. (Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Cancer, Knee arthroplasty, MDS, ET, Prostate cancer, Metal exposure
in
European Journal of Cancer
volume
47
issue
7
pages
1061 - 1071
publisher
IFAC & Elsevier Ltd.
external identifiers
  • wos:000290192600012
  • pmid:21227681
  • scopus:79952787641
ISSN
1879-0852
DOI
10.1016/j.ejca.2010.11.023
language
English
LU publication?
yes
id
5673d9cb-0157-411c-b399-f512af20f491 (old id 1777571)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/21227681?dopt=Abstract
date added to LUP
2011-02-01 12:29:24
date last changed
2017-08-27 03:35:26
@article{5673d9cb-0157-411c-b399-f512af20f491,
  abstract     = {BACKGROUND: An increasing number of young patients are undergoing knee arthroplasties. Thus, the long-term risks of having a knee prosthesis must be evaluated. This study focuses on the potential carcinogenic effects of the prosthesis; it is a long-term follow-up of all patients in Sweden between 1975 and 2006. METHODS: The incidence of cancer in a total population of operated individuals was compared to the overall national cancer incidence in Sweden by means of standardised incidence ratios. Analysis of cancer latency period was performed to identify potential aetiological factors. RESULTS: For male and female patients with rheumatoid arthritis (RA) or osteoarthritis (OA), the overall cancer risks were elevated, ranging from 1.10 (95% confidence interval (CI): 1.03-1.18) for men with OA to 1.26 (1.23-1.29) for men with RA. The greatest increases in risk were observed for the leukaemia subtypes, myelodysplastic syndromes (MDS) and essential thrombocytosis (ET), ranging from 3.31 (1.24-8.83) for ET in men with OA to 7.38 (1.85-29.51) for ET in women with RA. Increases in risk were also observed for breast cancer, prostate cancer and melanoma. The latency analysis revealed elevated risks late in the study period for both solid and haematopoietic cancers. However, only increases in MDS and possibly prostate cancer and melanoma rates appeared to be connected to the operation. CONCLUSION: This study showed that OA and RA arthroplasty patients have a significantly higher risk of cancer than the general population. Elevated risks of MDS and possibly prostate cancer and melanoma indicated a potential connection to exposure to metals in the implant. The observed excessive incidence of ET was likely associated with the inflammatory disease.},
  author       = {Wagner, Philippe and Olsson, Håkan and Lidgren, Lars and Robertsson, Otto and Ranstam, Jonas},
  issn         = {1879-0852},
  keyword      = {Cancer,Knee arthroplasty,MDS,ET,Prostate cancer,Metal exposure},
  language     = {eng},
  number       = {7},
  pages        = {1061--1071},
  publisher    = {IFAC & Elsevier Ltd.},
  series       = {European Journal of Cancer},
  title        = {Increased cancer risks among arthroplasty patients: 30year follow-up of the Swedish Knee Arthroplasty Register.},
  url          = {http://dx.doi.org/10.1016/j.ejca.2010.11.023},
  volume       = {47},
  year         = {2011},
}