Malignancies in patients with antineutrophil cytoplasmic antibody-associated vasculitis : A population-based cohort study
(2020) In Journal of Rheumatology 47(8). p.1229-1237- Abstract
Objective. Patients with ANCA-associated vasculitides (AAV) exhibit higher rates of malignancy than the general population. We assessed whether the cancer risk is increased in a well-characterized population-based cohort of AAV in southern Sweden, followed for a median time of 8 years. Methods. With case record review, the outcomes and malignancy development in a cohort of 195 patients with AAV [granulomatosis with polyangiitis (GPA), microscopic polyangiitis, and eosinophilic GPA] diagnosed between 1997 and 2010 were assessed. The patients were followed until death or December 31, 2015. The age- and sex-standardized incidence ratios (SIR) were estimated using the Swedish population data as a reference. Results. During the observation... (More)
Objective. Patients with ANCA-associated vasculitides (AAV) exhibit higher rates of malignancy than the general population. We assessed whether the cancer risk is increased in a well-characterized population-based cohort of AAV in southern Sweden, followed for a median time of 8 years. Methods. With case record review, the outcomes and malignancy development in a cohort of 195 patients with AAV [granulomatosis with polyangiitis (GPA), microscopic polyangiitis, and eosinophilic GPA] diagnosed between 1997 and 2010 were assessed. The patients were followed until death or December 31, 2015. The age- and sex-standardized incidence ratios (SIR) were estimated using the Swedish population data as a reference. Results. During the observation period of about 1500 person-years, we found 60 cancers in 52 of the 195 patients. SIR (95% CI) was 2.8 (2.1-3.6) for cancers at all sites, 1.8 (1.3-2.5) for all cancers excluding squamous cell carcinoma (SCC), 12.9 (8.4-18.8) for SCC, 4.3 (1.4-10.0) for bladder cancer, and 7.0 (1.4-20.5) for pancreatic cancer. Cumulative doses of cyclophosphamide (CYC) < 10 g were not associated with higher incidence of cancers other than SCC (SIR 1.63, 95% CI 0.8-2.9). Conclusion. In contrast to previous publications assessing malignancy risk in patients with AAV, we show in this population-based cohort of patients a persistent increased risk for overall malignancy, bladder cancer, and pancreatic cancer as well as a markedly increased risk for SCC. There was no increase in incidence of cancers other than SCC for those treated with < 10 g CYC.
(Less)
- author
- Heijl, Caroline LU ; Westman, Kerstin LU ; Höglund, Peter LU and Mohamma, Aladdin J.
- organization
- publishing date
- 2020
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Antineutrophil cytoplasmic antibodies, Granulomatosis with polyangiitis, Population, Vasculitis
- in
- Journal of Rheumatology
- volume
- 47
- issue
- 8
- pages
- 9 pages
- publisher
- Journal of Rheumatology Publishing Company Limited
- external identifiers
-
- pmid:31474595
- scopus:85079864470
- ISSN
- 0315-162X
- DOI
- 10.3899/jrheum.181438
- language
- English
- LU publication?
- yes
- id
- 577e95aa-c7d3-4e99-9162-58e76f5433a1
- date added to LUP
- 2021-01-08 14:13:46
- date last changed
- 2024-08-08 08:51:47
@article{577e95aa-c7d3-4e99-9162-58e76f5433a1, abstract = {{<p>Objective. Patients with ANCA-associated vasculitides (AAV) exhibit higher rates of malignancy than the general population. We assessed whether the cancer risk is increased in a well-characterized population-based cohort of AAV in southern Sweden, followed for a median time of 8 years. Methods. With case record review, the outcomes and malignancy development in a cohort of 195 patients with AAV [granulomatosis with polyangiitis (GPA), microscopic polyangiitis, and eosinophilic GPA] diagnosed between 1997 and 2010 were assessed. The patients were followed until death or December 31, 2015. The age- and sex-standardized incidence ratios (SIR) were estimated using the Swedish population data as a reference. Results. During the observation period of about 1500 person-years, we found 60 cancers in 52 of the 195 patients. SIR (95% CI) was 2.8 (2.1-3.6) for cancers at all sites, 1.8 (1.3-2.5) for all cancers excluding squamous cell carcinoma (SCC), 12.9 (8.4-18.8) for SCC, 4.3 (1.4-10.0) for bladder cancer, and 7.0 (1.4-20.5) for pancreatic cancer. Cumulative doses of cyclophosphamide (CYC) < 10 g were not associated with higher incidence of cancers other than SCC (SIR 1.63, 95% CI 0.8-2.9). Conclusion. In contrast to previous publications assessing malignancy risk in patients with AAV, we show in this population-based cohort of patients a persistent increased risk for overall malignancy, bladder cancer, and pancreatic cancer as well as a markedly increased risk for SCC. There was no increase in incidence of cancers other than SCC for those treated with < 10 g CYC.</p>}}, author = {{Heijl, Caroline and Westman, Kerstin and Höglund, Peter and Mohamma, Aladdin J.}}, issn = {{0315-162X}}, keywords = {{Antineutrophil cytoplasmic antibodies; Granulomatosis with polyangiitis; Population; Vasculitis}}, language = {{eng}}, number = {{8}}, pages = {{1229--1237}}, publisher = {{Journal of Rheumatology Publishing Company Limited}}, series = {{Journal of Rheumatology}}, title = {{Malignancies in patients with antineutrophil cytoplasmic antibody-associated vasculitis : A population-based cohort study}}, url = {{http://dx.doi.org/10.3899/jrheum.181438}}, doi = {{10.3899/jrheum.181438}}, volume = {{47}}, year = {{2020}}, }