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Knee and hip osteoarthritis and risk of nine cancers in a large real-world matched cohort study

Turkiewicz, Aleksandra LU ; Diaz, Yesika ; Duarte-Salles, Talita and Prieto-Alhambra, Daniel (2022) In Rheumatology (Oxford, England) 61(6). p.2325-2334
Abstract
Objectives
Joint replacement due to end-stage OA has been linked to incidence of several cancers. We aimed to estimate the association between newly diagnosed knee and hip OA and incidence of nine common cancer types.

Methods
We identified persons with incident knee or hip OA, aged ≥40 years, between 2009 and 2015 in the SIDIAP database in Catalonia, Spain. We matched up to three OA-free controls on age, sex and general practitioner. We followed participants from 1 year after OA diagnosis until migration, death, end of study at 31 December 2017 or incident cancer of: stomach, colorectal, liver, pancreas, lung, skin, breast, prostate and bladder. We used flexible parametric survival models, adjusted for confounders.... (More)
Objectives
Joint replacement due to end-stage OA has been linked to incidence of several cancers. We aimed to estimate the association between newly diagnosed knee and hip OA and incidence of nine common cancer types.

Methods
We identified persons with incident knee or hip OA, aged ≥40 years, between 2009 and 2015 in the SIDIAP database in Catalonia, Spain. We matched up to three OA-free controls on age, sex and general practitioner. We followed participants from 1 year after OA diagnosis until migration, death, end of study at 31 December 2017 or incident cancer of: stomach, colorectal, liver, pancreas, lung, skin, breast, prostate and bladder. We used flexible parametric survival models, adjusted for confounders. Estimates were corrected for misclassification using probabilistic bias analysis.

Results
We included 117 750 persons with knee OA and matched 309 913 persons without, with mean (S.D.) age of 67.5 (11.1) years and 63% women. The hip cohort consisted of 39 133 persons with hip OA and 116 713 controls. For most of the included cancers, the hazard ratios (HRs) were close to 1. The HR of lung cancer for knee OA exposure was 0.80 (95% CI: 0.71, 0.89) and attenuated to 0.98 (0.76, 1.27) in non-smokers. The hazard of colorectal cancer was lower in persons with both knee and hip OA by 10–20%.

Conclusions
Knee and hip OA are not associated with studied incident cancers, apart from lower risk of colorectal cancer. The often-reported protective association of knee OA with lung cancer is explained by residual confounding. (Less)
Please use this url to cite or link to this publication:
author
; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Rheumatology (Oxford, England)
volume
61
issue
6
article number
keab733
pages
2325 - 2334
publisher
Oxford University Press
external identifiers
  • pmid:34599812
  • scopus:85131218852
ISSN
1462-0332
DOI
10.1093/rheumatology/keab733
language
English
LU publication?
yes
id
bf8d836f-e1d2-4bea-b9b8-43902204d05e
date added to LUP
2021-11-09 10:00:24
date last changed
2022-07-17 04:41:35
@article{bf8d836f-e1d2-4bea-b9b8-43902204d05e,
  abstract     = {{Objectives<br/>Joint replacement due to end-stage OA has been linked to incidence of several cancers. We aimed to estimate the association between newly diagnosed knee and hip OA and incidence of nine common cancer types.<br/><br/>Methods<br/>We identified persons with incident knee or hip OA, aged ≥40 years, between 2009 and 2015 in the SIDIAP database in Catalonia, Spain. We matched up to three OA-free controls on age, sex and general practitioner. We followed participants from 1 year after OA diagnosis until migration, death, end of study at 31 December 2017 or incident cancer of: stomach, colorectal, liver, pancreas, lung, skin, breast, prostate and bladder. We used flexible parametric survival models, adjusted for confounders. Estimates were corrected for misclassification using probabilistic bias analysis.<br/><br/>Results<br/>We included 117 750 persons with knee OA and matched 309 913 persons without, with mean (S.D.) age of 67.5 (11.1) years and 63% women. The hip cohort consisted of 39 133 persons with hip OA and 116 713 controls. For most of the included cancers, the hazard ratios (HRs) were close to 1. The HR of lung cancer for knee OA exposure was 0.80 (95% CI: 0.71, 0.89) and attenuated to 0.98 (0.76, 1.27) in non-smokers. The hazard of colorectal cancer was lower in persons with both knee and hip OA by 10–20%.<br/><br/>Conclusions<br/>Knee and hip OA are not associated with studied incident cancers, apart from lower risk of colorectal cancer. The often-reported protective association of knee OA with lung cancer is explained by residual confounding.}},
  author       = {{Turkiewicz, Aleksandra and Diaz, Yesika and Duarte-Salles, Talita and Prieto-Alhambra, Daniel}},
  issn         = {{1462-0332}},
  language     = {{eng}},
  number       = {{6}},
  pages        = {{2325--2334}},
  publisher    = {{Oxford University Press}},
  series       = {{Rheumatology (Oxford, England)}},
  title        = {{Knee and hip osteoarthritis and risk of nine cancers in a large real-world matched cohort study}},
  url          = {{http://dx.doi.org/10.1093/rheumatology/keab733}},
  doi          = {{10.1093/rheumatology/keab733}},
  volume       = {{61}},
  year         = {{2022}},
}