Objectives The aim of this study was to determine if recommendations for cancer screening were well applied in rheumatoid arthritis (RA) patients. Frequency of each cancer and risk factors were also assessed.
Methods 970 patients with RA, according to ACR criteria, were included in the french COMEDRA study. A standardized questionnaire on comorbidities, including cancer, was fulfilled by a nurse or a clinical research assistant. Data were collected to assess cancer monitoring according to the french recommendation for breast (mammography each 2 years between 50 and 74 years old), cervical (smear each year after 25 years old, and after 2 normal spears each 3 years), prostate (digital rectal exam and Prostatic Specific Antigen (PSA) dosage after 50 years old, and then PSA dosage each 3 years if PSA level is <1 ng/mL or each year if PSA level is between 1 and 4 ng/mL), and colorectal cancer (Hemoccult® test each 2 years between 50 and 74 years old, and colonoscopy if fecal occult blood test is positive). Prostatic Specific Antigen (PSA) was sampled in men patients before the beginning of the study.
Results Data for 922/970 patients were analysable. There were 731 women and 191 men. 272/687 (39.6%) women who must have a screening (between 25 and 74 years) and 272/731 (37.2%) of the whole female population had adequate screening for breast, cervical and colorectal cancer (77.3% for 25-50 years, 29.6% for 50-65 years and 16% for 65-74 years). 22/147 (14.9%) men who must have a screening (50 to 74 years) and 54/191 (28.3%) of the whole male population had adequate screening for prostate and colon cancer.
58/922 (7.9%) of women and 12/191 (6.3%) of men had a history of cancer. Rate of cancer was: 27/731 (3.7%) for breast cancer; 10/731 (1.4%) for cervical cancer; 3/191 (1.6%) for prostate cancer; 6/922 (0.6%) for colorectal cancer; 9/922 (1%) for melanoma; 2/922 (0.2%) for lung cancer; 3/922 (0.3%) for lymphoma. 177/922 (19.2%) patients had more than 20 pack years smoking. 45/922 (4.5%) patients had an alcohol consumption above 2 glasses/day.
Conclusions Despite the possibility to have a monitoring detection of cancer free of charge in France, less than 40% of women and less than 30% of men had adequate cancer screening monitoring in this study. The most common past cancer were breast cancer for women and prostate for men.
Disclosure of Interest None declared
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