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While many studies have investigated the risk of cancer following exposure to tumour necrosis factor (TNF) inhibitors,1–3 data are scarce with respect to people with cancer prior to treatment.2 ,4 To our knowledge, no studies have looked at cancer risk following exposure to anti-TNF in patients with a history of premalignant conditions, such as cervical dysplasia and Barrett's oesophagus. Guidelines from the British Society for Rheumatology (BSR) advise caution when using anti-TNF in subjects with premalignant conditions.5 Given the uncertainties regarding the use of anti-TNF in people with premalignant conditions, we investigated the outcome of women with rheumatoid arthritis (RA) with a previous history of carcinoma in situ (CIS) of the cervix registered with the BSR Biologics Register.6
The BSR Biologics Register, established in 2001, is following two cohorts of patients: one cohort of patients with RA …
Contributors Study concept and design: LKM, KLH; acquisition of data: BSRBR Control Centre Consortium; analysis and interpretation of data: LKM, ASLL, JBG, ML, KDW, DPMS, KLH; drafting of manuscript: LKM, KLH. All authors contributed to critical revision of the manuscript for important intellectual content and approved the article for publication.
Funding LKM is funded by a Clinical Research Training Fellowship from the Medical Research Council (89923). The BSR receives restricted financial support from the pharmaceutical industry. This income finances a separate contract between the BSR and the University of Manchester for the administration of the BSRBR.
Competing interests None.
Patient consent Obtained.
Ethical approval The study was approved by the North-West Multicentre Research Ethics Committee.
Provenance and peer review Not commissioned; externally peer reviewed.