Survival of cancer in patients with rheumatoid arthritis: a follow-up study in Sweden of patients hospitalized with rheumatoid arthritis 1 year before diagnosis of cancer

Rheumatology (Oxford). 2011 Aug;50(8):1513-8. doi: 10.1093/rheumatology/ker143. Epub 2011 Apr 15.

Abstract

Objectives: Patients diagnosed with RA have an increased risk of some cancers. However, limited data are available on the important issue of prognosis of RA patients with cancer.

Methods: RA patients were identified from the Swedish Hospital Discharge Register by linkage to the Cancer Registry. Follow-up of patients was started from the date of diagnosis of cancer through year 2006. Hazard ratios (HRs) were calculated in cancer patients with RA compared with subjects without RA.

Results: A total of 1,411,163 cancer patients were identified in the database, of whom 6309 had a previous hospitalization for RA. Compared with all cancer patients without RA, patients with RA had a worse prognosis, with an HR of 1.29 and 1.31 for cause-specific and overall survival, respectively. For specific cancer sites, skin and breast cancers and non-Hodgkin's lymphoma showed worst survival. Age stratification did not change the results.

Conclusion: Cancer patients with a previous hospitalization for RA had a worse prognosis for all and many site-specific cancers compared with patients without RA, independent of age at diagnosis and tumour staging. Improvement of survival for cancer patients with RA may require a multidisciplinary approach to accommodate the comorbidity.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Arthritis, Rheumatoid / epidemiology*
  • Comorbidity
  • Databases, Factual
  • Female
  • Follow-Up Studies
  • Hospitalization*
  • Humans
  • Male
  • Neoplasms / epidemiology*
  • Prognosis
  • Registries
  • Risk Assessment
  • Survival Rate
  • Sweden / epidemiology