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1.
Pei-Chang Lee Yu-Wen Hu Man-Hsin Hung Chun-Chia Chen Han-Chieh Lin Fa-Yauh Lee Yi-Ping Hung Vincent Yi-Fong Su Sang-Hue Yen Cheng-Hwai Tzeng Tzeon-Jye Chiou Chia-Jen Liu 《The American journal of medicine》2013
Objective
To evaluate the risk of cancer among patients diagnosed with hemorrhoids and benign anal inflammatory lesions.Methods
A population-based, retrospective cohort study was conducted that included patients diagnosed with hemorrhoids or benign inflammatory anal lesions (eg, anal fissure, fistula, and perianal abscesses) that were registered in the National Health Insurance Research Database in Taiwan between January 1, 2000 and December 31, 2010. Standardized incidence ratios (SIRs) were calculated to compare the cancer incidence of these patients to the general population.Results
During a median observation period of 6.23 years, 3080 cancers developed among 70,513 hemorrhoid patients, with a follow-up period of 438,425.6 person-years, entailing the SIR of 1.52 (95% confidence interval [CI], 1.47-1.58). Increased cancer risk (SIR 1.16; 95% CI, 1.11-1.21) was still noted even after excluding the first year of observation. Significant long-term risk for colorectal cancer (SIR 1.50; 95% CI, 1.35-1.66) and prostate cancer (SIR 1.40; 95% CI, 1.17-1.66) was observed after corrections were made for multiple comparisons. In contrast, there was no remarkable increase in cancer risk for patients with inflammatory anal lesions when cancers detected within the first year of diagnosis were excluded.Conclusion
The presence of hemorrhoids is associated significantly with a long-term risk of developing colorectal cancer or prostate cancer. In contrast, benign inflammatory anal lesions do not appear to increase the risk of malignancy. 相似文献2.
Toru Yamada Ayako Nakajima Eisuke Inoue Eiichi Tanaka Atsuo Taniguchi Shigeki Momohara Hisashi Yamanaka 《Rheumatology international》2011,31(11):1487-1492
To determine the incidence of malignancy and site-specific malignancies in Japanese patients with rheumatoid arthritis (RA).
In a prospective large observational cohort study named IORRA, 7,566 patients with RA were enrolled from April 2001 to April
2005 and were followed up to October 2005. Occurrence of malignancy was originally collected by patient reports of IORRA survey
biannually from April 2001 to October 2005, and was confirmed by medical records. Standardized incidence rate (SIR) of the
observed-to-expected cancer incidence and 95% confidence intervals (95% CI) were then calculated. Factors obtained at first
enrollment in IORRA were assessed for association with risk of malignancy using the Cox proportional hazards model. A total
of 177 malignancies in 173 patients (58 in men, 115 in women) were identified during the observation period of 25,567 person-years.
The age- and sex-standardized incidence rate of malignancy was 437.1 (men, 706.8; women, 366.1) per 100,000 person-years.
The SIR of malignancy was slightly excess (SIR 1.18, [95% CI 1.02–1.37]) in all patients, but 1.29 (95% CI 0.99–1.67) in men,
and 1.13 (95% CI 0.94–1.36) in women. A significant excess of lymphoma (SIR 6.07, [95% CI 3.71–9.37]) and lung cancer (SIR
2.29, [95% CI 1.57–3.21]), whereas decreased incidence of colorectal cancer (SIR 0.49, [95% CI 0.26–0.83]), were found. Male
gender and older age were identified as risk factors for malignancy. A slight excess in the incidence of overall malignancy
and highly excess of lymphoma in Japanese RA patients was demonstrated. 相似文献
3.
Incidence of melanoma and other malignancies among rheumatoid arthritis patients treated with methotrexate 总被引:2,自引:0,他引:2
Buchbinder R Barber M Heuzenroeder L Wluka AE Giles G Hall S Harkness A Lewis D Littlejohn G Miller MH Ryan PF Jolley D 《Arthritis and rheumatism》2008,59(6):794-799
OBJECTIVE: To determine cancer risk in a cohort of 459 rheumatoid arthritis (RA) patients treated with methotrexate in community practice. METHODS: All RA patients who started methotrexate prior to June 1986 and were attending 1 of 6 rheumatologists were studied. Demographic data were matched to the State Cancer Registry to identify all malignancies (except nonmelanoma skin cancer) for 1983-1998, and to the National Death Index to identify all deaths to the end of 1999. Followup started on the date when methotrexate was started and ended either on the last confirmed date on which the patient was seen by the rheumatologist or at death. Standardized incidence ratios (SIRs) were calculated using state population cancer rates stratified by sex, age (in 5-year groups), and calendar year. RESULTS: There were 4,145 person-years of followup (average 9.3 years). Eighty-seven malignancies were identified (14 before, 64 during, and 9 after the followup period). There was an estimated 50% excess risk of malignancy among methotrexate-exposed RA patients relative to the general population (SIR 1.5, 95% confidence interval [95% CI] 1.2-1.9), with a 3-fold increase in melanoma (SIR 3.0, 95% CI 1.2-6.2), a 5-fold increase in non-Hodgkin's lymphoma (SIR 5.1, 95% CI 2.2-10.0), and an almost 3-fold increase in lung cancer (SIR 2.9, 95% CI 1.6-4.8). CONCLUSION: Compared with the general population, methotrexate-treated RA patients have an increased incidence of melanoma, non-Hodgkin's lymphoma, and lung cancer. There may be a role for regular skin cancer screening for all RA patients, particularly those receiving immunosuppressive therapy. 相似文献
4.
An international cohort study of cancer in systemic lupus erythematosus 总被引:14,自引:0,他引:14
Bernatsky S Boivin JF Joseph L Rajan R Zoma A Manzi S Ginzler E Urowitz M Gladman D Fortin PR Petri M Edworthy S Barr S Gordon C Bae SC Sibley J Isenberg D Rahman A Aranow C Dooley MA Steinsson K Nived O Sturfelt G Alarcón G Senécal JL Zummer M Hanly J Ensworth S Pope J El-Gabalawy H McCarthy T St Pierre Y Ramsey-Goldman R Clarke A 《Arthritis and rheumatism》2005,52(5):1481-1490
OBJECTIVE: There is increasing evidence in support of an association between systemic lupus erythematosus (SLE) and malignancy, but in earlier studies the association could not be quantified precisely. The present study was undertaken to ascertain the incidence of cancer in SLE patients, compared with that in the general population. METHODS: We assembled a multisite (23 centers) international cohort of patients diagnosed as having SLE. Patients at each center were linked to regional tumor registries to determine cancer occurrence. Standardized incidence ratios (SIRs) were calculated as the ratio of observed to expected cancers. Cancers expected were determined by multiplying person-years in the cohort by the geographically matched age, sex, and calendar year-specific cancer rates, and summing over all person-years. RESULTS: The 9,547 patients from 23 centers were observed for a total of 76,948 patient-years, with an average followup of 8 years. Within the observation interval, 431 cancers occurred. The data confirmed an increased risk of cancer among patients with SLE. For all cancers combined, the SIR estimate was 1.15 (95% confidence interval [95% CI] 1.05-1.27), for all hematologic malignancies, it was 2.75 (95% CI 2.13-3.49), and for non-Hodgkin's lymphoma, it was 3.64 (95% CI 2.63-4.93). The data also suggested an increased risk of lung cancer (SIR 1.37; 95% CI 1.05-1.76), and hepatobiliary cancer (SIR 2.60; 95% CI 1.25, 4.78). CONCLUSION: These results support the notion of an association between SLE and cancer and more precisely define the risk of non-Hodgkin's lymphoma in SLE. It is not yet known whether this association is mediated by genetic factors or exogenous exposures. 相似文献
5.
Chang-Fu Kuo Shue-Fen Luo Lai-Chu See I-Jun Chou Hsiao-Chun Chang Kuang-Hui Yu 《Rheumatology international》2013,33(2):355-360
There are few nationwide population studies on the epidemiology of rheumatoid arthritis (RA). Here, we present the epidemiologic features and mortality rates of RA in Taiwan. The catastrophic illness registry of the Taiwan National Health Insurance Research Database and the National Death Registry of Taiwan were used to estimate the incidence and prevalence of RA and its associated mortality rates. All-cause and cause-specific standardized mortality ratios (SMRs) were calculated and compared to the corresponding ratios of the general population in 2002. The study comprised 15,967 incident RA cases (3,562 men; 12,405 women) occurring from 2002 through 2007. The annual incidence of RA was 15.8 cases (men, 10.1; women, 41.0) per 100,000 population. The period prevalence was 97.5 cases (men, 37.4; women, 159.5) per 100,000 population. During 67,010 person-years of follow-up, 985 deaths (372 men; 613 women) were identified, and this corresponded to a crude mortality rate of 14.7 deaths (men, 25.0; women, 11.8) per 1,000 person-years. Compared to female patients, male patients had a higher risk for mortality (log-rank test, p < 0.001). RA patients had an SMR of 1.25 (95 % confidence interval [CI], 1.18–1.33) for all-cause mortality. Compared to the general population, RA patients of both genders in this cohort had a significantly higher risk of mortality from infection (SMR, 2.49) and gastrointestinal diseases (SMR, 1.76). RA incidence and prevalence were higher in women than in men. Mortality was higher in men than in women. Compared to the general population, RA patients had a higher risk of death, particularly from infection and gastrointestinal diseases. 相似文献
6.
Jolanda Cibere MD John Sibley MD May Haga BA 《Arthritis \u0026amp; Rheumatology》1997,40(9):1580-1586
Objective. To determine the relative risks of malignancy and of site-specific malignancies in patients with rheumatoid arthritis (RA). Methods. In a prospective cohort study, 862 patients with RA (96% white) were enrolled from 1966 to 1974 and were followed up for up to 35 years (mean 17.4 years) at the University of Saskatchewan Rheumatic Disease Unit. All diagnoses of cancer were crossreferenced with the Provincial Cancer Registry. Expected cancer incidence rates were determined based on province of Saskatchewan population statistics matched to each study patient for age, sex, and calendar year. Standardized incidence ratios (SIRs) of the observedto-expected cancer incidence and 95% confidence intervals (95% CI) were then calculated. Results. A total of 136 cases of cancer were observed compared with 168 expected (SIR 0.80, P = 0.011 [95% CI 0.67–0.95]). The relative risk of colorectal malignancy was significantly reduced in the RA study population (SIR 0.52, P = 0.037 [95% CI 0.25–0.96]). A significant excess of leukemia was found (SIR 2.47, P = 0.026 [95% CI 1.12–4.69]), whereas the incidence rates for Hodgkin's disease and non-Hodgkin's lymphoma and all other site-specific malignancies were not found to be significantly different from general population rates. Conclusion. In our cohort of RA patients, colorectal cancer was detected in only half the expected number of patients. This risk reduction may be related to long-term nonsteroidal antiinflammatory drug (NSAID) use in RA, as has been suggested in several other studies of long-term NSAID use. An increased risk of leukemia was confirmed. This may be due to the persistent immune stimulation associated with RA itself, since other potential explanatory factors for increased leukemia were not apparent. Despite the excess of hemopoietic malignancy and despite treatment of RA with potentially oncogenic agents, the overall risk of malignancy was reduced in this RA cohort. 相似文献
7.
BackgroundAn increased risk of malignancy in patients with systemic lupus erythematosus has been reported, but rarely in Asian populations. We aimed to investigate the relative risk of cancer and to identify the high-risk group for cancer in patients with lupus.MethodsWe conducted a retrospective, nationwide cohort study that included 11,763 patients with lupus without a history of malignancies, using the national health insurance database of Taiwan from 1996 to 2007. Standardized incidence ratios (SIRs) of cancers were analyzed.ResultsA total of 259 cancers were observed in patients with lupus. An elevated risk of cancer among those with systemic lupus erythematosus was noted (SIR 1.76; 95% confidence interval [CI] 1.74-1.79), especially for hematologic malignancies (SIR 4.96; 95% CI 4.79-5.14). Younger patients had a greater risk ratio of cancer than the general population, and the risk ratio decreased with age. The risk ratio of cancer decreased with time, yet remained elevated compared with that of the general population. The risk of non-Hodgkin lymphoma was greatest (SIR 7.27) among hematologic cancers. Among solid tumors, the risk was greatest for cancers of the vagina/vulva (SIR 4.76), nasopharynx (SIR 4.18), and kidney (SIR 3.99). An elevated risk for less common cancers, including those of the brain, oropharynx, and thyroid glands, was also observed.ConclusionPatients with lupus are at increased risk of cancers and should receive age- and gender-appropriate malignancy evaluations, with additional assessment for vulva/vagina, kidney, nasopharynx, and hematologic malignancy. Continued vigilance for development of cancers in follow-up is recommended. 相似文献
8.
Cancer in rheumatoid arthritis: occurrence, mortality, and associated factors in a South European population 总被引:2,自引:0,他引:2
Abásolo L Júdez E Descalzo MA González-Alvaro I Jover JA Carmona L;EMECAR Study Group 《Seminars in arthritis and rheumatism》2008,37(6):388-397
OBJECTIVES: To estimate the prevalence, incidence, mortality, and predictors of cancer in patients with rheumatoid arthritis (RA). METHODS: We compared the incidence of cancer and the mortality by cancer in a cohort of 789 randomly selected RA patients (1999-2005) with the expected ones in the general population. We estimated standardized incidence ratios (SIR) and standardized mortality ratios (SMR) by indirect age and sex standardization. Additionally, we analyzed by generalized linear models the association of various predictors with cancer incidence, obtaining incidence rate ratios (IRR) with 95% confidence intervals (CI). RESULTS: The SIR of cancer in RA is 1.23 (95% CI: 0.78-1.85). By cancer type, there is an increased risk of leukemia, non-Hodgkin's lymphoma, and lung cancer in RA compared with the general population of the same sex and age. The SMR of cancer is 1.0 (95% CI: 0.53-1.7). By cancer type, RA patients with lung or kidney cancer have higher mortality than expected. Being male, elderly, with longstanding disease, and having used any cytotoxic drugs apart from methotrexate are confirmed as predictive factors for cancer. Additional independent predictors are increases in blood leukocyte counts (IRR per 3000 u/mm3 increase: 1.88 (95% CI: 1.6 -2.1)) and decreases in serum hemoglobin (IRR per 2 g/l decrease: 1.88 (95% CI: 1.19 -2.94)). CONCLUSIONS: The overall incidence and mortality of cancer in RA is not greater than the expected, although there is an increased risk of hematopoietic and lung cancers in RA patients compared with the general population. Hemoglobin and leukocyte counts may help to identify RA patients at risk for cancer. 相似文献
9.
Faurschou M Sorensen IJ Mellemkjaer L Loft AG Thomsen BS Tvede N Baslund B 《The Journal of rheumatology》2008,35(1):100-105
OBJECTIVE: To describe the incidence of malignancies in a cohort of Danish patients with Wegener's granulomatosis (WG) and to investigate the cancer risk associated with cyclophosphamide (CYC) -therapy in WG. METHODS: In total, 293 patients diagnosed with WG between 1973 and 1999 were studied. Cancer incidence in the cohort was assessed through 2003 by linkage to the Danish Cancer Registry and compared to that of the general population by calculation of standardized incidence ratios (SIR). Analyses were stratified according to treatment with low cumulative CYC doses (< or = 36 g) and high doses (> 36 g, corresponding to treatment with 100 mg CYC/day for > 1 year). RESULTS: Fifty cancers occurred during 2121 person-years of followup (SIR of cancer of 2.1, 95% CI 1.5-2.7). Significantly increased SIR were observed for acute myeloid leukemia (AML; SIR 19.6, 95% CI 4.0-57), bladder cancer (SIR 3.6, 95% CI 1.2-8.3), and non-melanoma skin cancers (SIR 4.7, 95% CI 2.8-7.3). Leukemias and bladder cancers were diagnosed 6.9-18.5 years after initiation of CYC therapy. The risk of these malignancies was not increased for patients who never received CYC or for patients treated with cumulative CYC doses < or = 36 g. In contrast, high risks of AML (SIR 59.0, 95% CI 12-172) and bladder cancer (SIR 9.5, 95% CI 2.6-24) were observed for patients treated with cumulative CYC doses > 36 g. CONCLUSION: Treatment with high cumulative CYC doses implies a substantial risk of late-occurring, serious malignancies in WG. Patients with WG should be monitored for development of cancer for several decades after cessation of CYC therapy. These findings emphasize the need for development of new treatment regimens in WG. 相似文献
10.
Dam Kim Soo-Kyung Cho Chan-Bum Choi Jae-Bum Jun Tae-Hwan Kim Hye-Soon Lee Jisoo Lee Shin-Seok Lee Dae-Hyun Yoo Wan-Hee Yoo Yoon-Kyoung Sung Sang-Cheol Bae 《Rheumatology international》2016,36(9):1205-1214
Rheumatoid arthritis (RA) patients have high risk for osteoporosis and fracture. We aimed to identify the incidence rate and risk factors of fractures in Asian RA patients. A total of 3557 RA patients in the KORean Observational study Network for Arthritis (KORONA) were included and observed over a mean follow-up of 18 months. A fracture was assessed as total, major, or minor fractures; major fracture was defined as a vertebral or hip fracture, and the other fractures were classified as minor fractures. The standardized incidence ratio (SIR) of fracture in RA patients was calculated compared with general population, and possible risk factors for fractures were explored using multivariable logistic regression analyses. A total of 194 patients with 215 fractures were observed, and the SIR of the total fracture in RA patients was 2.2 [95 % confidence interval (CI) 1.9–2.6]. The SIRs of major and minor fractures were 1.5 (CI 1.1–2.0) and 3.0 (CI 2.5–3.7), respectively. Advanced age [odds ratio (OR) 1.03, CI 1.02–1.05, p < 0.01] and having history of prior fracture (OR 2.17, CI 1.54–3.08, p < 0.01) were risk factors for total fractures. In addition, higher HAQ increased fracture risk (OR 2.02, CI 1.05–3.89, p = 0.04), whereas the use of bisphosphonate showed protective effect for future fractures (OR 0.34, CI 0.14–0.87, p = 0.02) in patients with osteoporosis. RA patients had a 2.2-fold increased risk of fractures as compared with general population. In Asian RA patients, advanced age and history of prior fracture were the most important risk factors for new fractures. 相似文献
11.
Lazarus MN Robinson D Mak V Møller H Isenberg DA 《Rheumatology (Oxford, England)》2006,45(8):1012-1015
OBJECTIVE: To compare the incidence of subsequent cancers in a cohort of patients with primary Sj?gren's syndrome (pSS) with that of the general population in the same region of England. METHODS: A retrospective analysis was carried out on 112 patients who had attended the out-patients department at University College Hospital, London, from 1979 onwards. Patients were followed up from diagnosis of pSS to diagnosis of first subsequent cancer, death, loss to follow-up or 31 December 2003 (the censoring date) to determine the person-years at risk for each individual. The expected numbers of subsequent cancers were calculated from sex-/age-/period-specific rates for the general population of southeast England, derived from registrations at the Thames Cancer Registry. Standardized incidence ratios (SIRs) were then calculated as the ratio of observed to expected numbers of cancers, along with 95% confidence intervals (CIs). Separate analyses were performed for all malignant cancers combined, lymphomas and non-lymphoid cancers. RESULTS: Among the 112 patients with pSS, 25 developed cancer (either before or after development of pSS), with lymphoma occurring in 11 cases. Nine patients had two cancers. There was a significantly elevated incidence of lymphomas in pSS patients compared with the general population (SIR 37.5, 95% CI 20.7-67.6). For non-lymphoid cancer, the observed increase in incidence was small and not statistically significant (SIR 1.5, 95% CI 0.9-2.6). CONCLUSION: This study confirms that there is an increased incidence of lymphoma in patients with pSS. An increase in the incidence of other cancers was not proven but the observation that some patients developed more than one cancer raises the possibility that there may be a subgroup of patients who are at greater risk of developing cancer. 相似文献
12.
Iannitto E Minardi V Callea V Stelitano C Calvaruso G Tripodo C Quintini G De Cantis S Ambrosetti A Pizzolo G Franco V Florena AM Abbadessa V 《European journal of haematology》2006,76(2):134-140
OBJECTIVES: Solid second primary cancers (SPC) have become an issue of extensive research. The purpose of the present study was to estimate the standardised incidence ratio (SIR) and the absolute excess risk (AER) of SPC in patients with splenic marginal zone lymphoma (SMZL). METHODS: We investigated the incidence of additional cancers in 129 patients consecutively diagnosed with SMZL in three Italian haematological centres, asking the cooperating doctors for additional information on initial and subsequent therapies and on the onset and type of second cancers. RESULTS: Twelve SPC were recorded (9.3%); the 3- and 5-yr cumulative incidence rates were 5.5% and 18.3% respectively, with an SIR of 2.03 [95% confidence interval (CI): 1.05-3.56; P < 0.05; AER = 145.81]. Of 12 SPC observed, four were urinary tract neoplasms (SIR, 3.70; 95% CI: 1.01-9.48; P < 0.05; AER = 70.06), four were lung cancers (SIR, 9.16; 95% CI: 1.41-13.25; P < 0.05; AER = 85.50) and the other four were hepatic carcinoma, endometrial cancer, breast cancer and colorectal cancer. CONCLUSIONS: Our findings evidence a high frequency of additional cancers in patients with SMZL and suggest that the incidence rate of SPC is significantly different from that expected in the general population. The frequency of cases with urinary tract and lung malignancies in our series is higher than expected. Although confirmatory data are needed, it is our opinion that SMZL patients are at risk of second cancer and should be carefully investigated on diagnosis and monitored during the follow-up. 相似文献
13.
Risk of cancers of the oesophagus and stomach by histology or subsite in patients hospitalised for pernicious anaemia 总被引:3,自引:0,他引:3
BACKGROUND: Although pernicious anaemia is an established risk factor for stomach cancer, data by anatomical subsite are not available. Moreover, a previous suggestion of a link to increased risk of oesophageal cancer needs further exploration. METHODS: We followed 21 265 patients hospitalised for pernicious anaemia in Sweden from 1965 to 1999 for an average of 7.1 years. Standardised incidence ratio (SIR) adjusted for sex, age, and calendar year was used to estimate relative risk, using the Swedish nationwide cancer incidence rates as reference. RESULTS: Significant excess risks for squamous cell carcinoma of the oesophagus, and stomach cancer distal to the cardia, were observed in pernicious anaemia patients (SIR 3.3 (95% confidence interval (CI) 2.4-4.4); SIR 2.4 (95% CI 2.1-2.7), respectively). The excess risks increased with increasing follow up duration. Among distal stomach cancers, the most conspicuous excess risk was for carcinoid tumours (SIR 26.4 (95% CI 14.8-43.5)). Compared with the general population, no significant increased risk was observed for adenocarcinoma of the oesophagus (SIR 1.7 (95% CI 0.7-3.4)) or gastric cardia (SIR 1.2 (95%CI 0.6-2.0)). CONCLUSIONS: Achlorhydria following type A atrophic gastritis is associated with an elevated risk of adenocarcinoma of the non-cardia stomach, and surprisingly, with a risk of oesophageal squamous cell carcinoma. In contrast, no significant association, either positive or negative, was found with oesophageal or cardia adenocarcinoma. The mechanism for the observed increased risk of oesophageal squamous cell carcinoma warrants further study. 相似文献
14.
Hai-Long Wang Yong-Ming Zhou Guang-Zhao Zhu Zhu Yang Bao-Jin Hua 《Clinical rheumatology》2018,37(1):81-85
Patients with Rheumatic diseases (RDs) are at an increased risk of malignancies compared with the general population. The aim of this study was to examine the relative frequency of several cancers in a single homogeneous cohort of patients with different RDs. Patients diagnosed with rheumatoid arthritis (RA), Ankylosing spondylitis (AS), Sjögren’s syndrome (SS), systemic lupus erythematosus (SLE), systemic sclerosis (SSc), dermatomyositis (DM), or polymyositis were included. Out of 3982 adult residents admitted to the division of rheumatology, 61 malignancies were observed. The 2009 National Central Cancer Registry (NCCR) of China served as the reference for calculating standardized ratio (SR). The malignancy frequency had no difference between RDs with malignancy and the general population. Patients with SS and DM/PM showed an increased risk of non-Hodgkin’s lymphoma (SR for SS patients = 9.709, 95% confidence interval (CI) = 4.602 to 17.916; SR for DM/PM = 35.714, 95% CI = 25.001 to 49.527). Patients with DM/PM and SSc showed an increased risk of lung cancer (SR for DM/PM = 10.638, 95% CI = 5.245 to 19.131; SR for SSc patients = 7.752, 95% CI = 3.295 to 15.309). Patients with SS and DM/PM showed an increased risk of ovary cancer (SR for SS patients = 8.177, 95% CI = 3.566 to 15.888; SR for DM/PM = 32.258, 95% CI = 22.126 to 45.490). Patients with SLE showed an increased risk of cervix cancer (SR for AS patients = 6.897, 95% CI = 2.748 to 14.144). Patients with AS showed an increased risk of pancreas cancer (SR for AS patients = 7.576, 95% CI = 2.181 to 15. 071). Different RDs have an increased risk of particular cancers. Among hematologic cancers, the risk of non-Hodgkin’s lymphoma was higher than general population. Among solid tumors, the risk of cancers of the lung, ovary, cervix, and pancreas was higher than general population. 相似文献
15.
Marta Fantò Mario Stefano Peragallo Mario Pietrosanti Roberta Di Rosa Andrea Picchianti Diamanti Simonetta Salemi Raffaele D’Amelio 《Internal and emergency medicine》2016,11(1):31-40
Systemic inflammatory rheumatic diseases are associated with an increased risk of malignancy, in particular of lymphoproliferative disorders. Chronic inflammation, due to the disease itself, generates a microenvironment able to promote cancer development, but it is still controversial whether immunosuppressive therapy may contribute to carcinogenesis. The aim of the study was to evaluate the risk of malignancy in 399 patients affected by rheumatoid arthritis (RA), psoriatic arthritis and ankylosing spondylitis, all treated with either tumor necrosis factor α-inhibitors plus disease-modifying anti-rheumatic drugs (DMARDs) or DMARDs alone. The risk of malignancy in this cohort of patients, observed in the period between 2005 and 2011 at S. Andrea Hospital-Sapienza University of Rome, was compared with that of the general Italian population, matched for age, sex, and area of residence. Fourteen (3.5 %) malignancies, five of which were hematologic, have been observed. The overall cancer risk was not significantly increased in comparison to the general population, whereas the risk of hematologic malignancies appeared significantly higher in RA patients (SIR 4.94, 95 % CI 1.35–12.64), particularly in female gender (SIR 6.9, 0.95 % CI 1.88–17.66). No significant association between therapy and malignancy was demonstrated in RA patients. 相似文献
16.
This study aimed to evaluate cancer risk and possible risk factors in patients diagnosed with empyema.A total of 31,636 patients with newly diagnosed empyema between January 1, 1999 and December 31, 2010 were included in this study. Standardized incidence ratios (SIRs) were calculated to compare the cancer incidence in these empyema patients to that in the general population. Adjusted hazard ratios were also calculated to investigate whether characteristics increased cancer risk.During the 12-year study period, 2,654 cancers occurred in 31,636 patients with empyema, yielding an SIR of 2.67 (95% confidence interval [CI] 2.57–2.78). We excluded cancer that occurred within 1 year to avoid surveillance bias. The cancer risk remained significantly increased (SIR 1.50, 95% CI 1.41–1.58). Specifically, patients with empyema had higher SIR of cancers of the head and neck (1.50, 95% CI 1.41–1.58), esophagus (2.56, 95% CI 1.92–3.33), stomach (1.49, 95% CI 1.16–1.89), liver and biliary tract (2.18, 95% CI 1.93–2.45), and lung and mediastinum (1.62, 95% CI 1.39–1.86). Age ≥ 60, male sex, diabetes mellitus, and liver cirrhosis were independent risk factors for cancer development.Our study demonstrates an increased incidence of cancer development in patients with empyema, and patients’ age ≥ 60, men, and those with diabetes mellitus and liver cirrhosis showed a higher incidence of developing cancer compared to the general population. The association between such kind of infection and secondary malignancy may be elucidated by further study. 相似文献
17.
Karlén P Löfberg R Broström O Leijonmarck CE Hellers G Persson PG 《The American journal of gastroenterology》1999,94(4):1047-1052
OBJECTIVE: There is an increased risk of colorectal cancer among patients with ulcerative colitis (UC). However, the overall and site specific cancer risks in these patients have been investigated to a limited extent. To study the association between UC and cancer, a population-based study of 1547 patients with UC in Stockholm diagnosed between 1955 and 1984 was carried out. METHODS: The patients were followed in both the National Cancer Register and the National Cause of Death Register until 1989. For comparisons, regional cancer incidence rates in Stockholm County were used together with individually computed person-years at risk in the UC disease cohort. RESULTS: A total of 121 malignancies occurred among 97 individuals as compared with 89.8 expected (standardized morbidity ratio [SMR] = 1.4; 95% confidence interval (CI), 1.1-1.6). Overall, an excess number of colorectal cancers (SMR, 4.1; 95% CI, 2.7-5.8), and hepatobiliary cancers in men (SMR = 6.0; 95% CI, 2.8-11.1) associated with primary sclerosing cholangitis, was observed. The risk of pulmonary cancer was decreased (SMR = 0.3; 95% CI, 0.1-0.9). In all, 91 extracolonic malignancies were observed, compared with the 82.3 expected (SMR = 1.11; 95% CI, 0.9-1.3). CONCLUSIONS: In UC patients, the overall cancer incidence is increased mainly because of an increased incidence of colorectal and hepatobiliary cancer. This increase is partly counterbalanced by a decreased risk of pulmonary cancer compared with that in the general population. 相似文献
18.
Incidence of cancer in the course of chronic pancreatitis 总被引:8,自引:0,他引:8
Talamini G Falconi M Bassi C Sartori N Salvia R Caldiron E Frulloni L Di Francesco V Vaona B Bovo P Vantini I Pederzoli P Cavallini G 《The American journal of gastroenterology》1999,94(5):1253-1260
OBJECTIVE: Chronic pancreatitis patients appear to present an increased incidence of pancreatic cancer. The aim of the study was to compare the incidence of cancer, whether pancreatic or extrapancreatic, in our chronic pancreatitis cases with that in the population of our region. METHODS: We analyzed 715 cases of chronic pancreatitis with a median follow-up of 10 yr (7287 person-years); during this observation period they developed 61 neoplasms, 14 of which were pancreatic cancers. The cancer incidence rates were compared, after correction for age and gender, with those of a tumour registry. RESULTS: We documented a significant increase in incidence of both extrapancreatic (Standardized Incidence Ratio [SIR], 1.5; 95% confidence interval [CI], 1.1-2.0; p <0.003) and pancreatic cancer (SIR, 18.5; 95% CI, 10-30; p <0.0001) in chronic pancreatitis patients. Even when excluding from the analysis the four cases of pancreatic cancer that occurred within 4 yr of clinical onset of chronic pancreatitis, the SIR is 13.3 (95% CI, 6.4-24.5; p <0.0001). If we exclude these early-onset cancers, there would appear to be no increased risk of pancreatic cancer in nonsmokers, whereas in smokers this risk increases 15.6-fold. CONCLUSIONS: The risks of pancreatic and nonpancreatic cancers are increased in the course of chronic pancreatitis, the former being significantly higher than the latter. The very high incidence of pancreatic cancer in smokers probably suggests that, in addition to cigarette smoking, some other factor linked to chronic inflammation of the pancreas may be responsible for the increased risk. 相似文献
19.
Systemic lupus erythematosus and the risk of malignancy. 总被引:7,自引:0,他引:7
The objective of this study was to determine the relative risks of malignancy and of site-specific malignancies in patients with systemic lupus erythematosus (SLE). A cohort of 297 patients (91% Caucasian) with SLE were seen between 1975 and 1994 and followed for a mean of 12 years at the University of Saskatchewan Rheumatic Disease Unit. Expected cancer incidence rates were determined based on Province of Saskatchewan population statistics matched to each study patient for age, sex and calendar year of follow-up. Standardized incidence ratios (SIRs) of observed to expected cancers and 95% confidence intervals (95% CI) were calculated. A total of 27 cases of cancer were observed, whereas only 16.9 were expected (SIR 1.59 (95% CI 1.05-2.32)). For site-specific malignancies, an excess of cancer of the cervix (SIR 8.15 (95% CI 1.63-23.81)) as well as hemopoietic malignancy (SIR 4.9 (95% CI 1.57-11.43)) was found. The hemopoietic cancers were predominantly non-Hodgkin's lymphoma (SIR 7.01 (95% CI 1.88-17.96)). We did not find an association of malignancy with known risk factors, including use of cytotoxic agents. Increased risk of malignancy, notably non-Hodgkin's lymphoma and perhaps cervical cancer, should be regarded as a complication of SLE. 相似文献
20.
Masahiro Tajika Keitaro Matsuo Hidemi Ito Dai Chihara Vikram Bhatia Shinya Kondo Tsutomu Tanaka Nobumasa Mizuno Kazuo Hara Susumu Hijioka Hiroshi Imaoka Kazuya Matsumoto Tsuneya Nakamura Yasushi Yatabe Kenji Yamao Yasumasa Niwa 《Journal of gastroenterology》2014,49(5):843-852