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Rheumatoid Arthritis and Cancer

February 2007 - A study by UK researchers led by Dr Alan Silman, an epidemiologist with the University of Manchester and published in Arthritis & Rheumatism has investigated the incidence of cancer in patients with rheumatoid arthritis (RA) and whether this is associated with a decreased survival rate. Researchers explain that patients with RA, a chronic inflammatory autoimmune disease, are known to have at least twice the risk of death from disease compared to the general population. However, it has been unclear whether this vulnerability includes cancer mortality. The study found that RA may increase the risk of dying from cancer but not developing it.

The study followed 2105 patients in Norfolk with recent onset inflammatory polyarthritis (a large proportion of which evolve into RA) over a 10-year period. They identified 123 cases of cancer affecting bone, lung, breast, prostate, urinary tract, colon, brain, digestive, respiratory, and central nervous systems, blood cells and cancerous tumors. They compared these findings with rates in the general population adjusting for age and sex. Researchers found that the overall incidence of cancer was not increased in the study group. However, the risk of blood cell cancers was increased, reflecting a known association between RA and lymphoma. Significantly, the study also found a 40 per cent increase in mortality in patients who suffered both inflammatory polyarthritis (IP), or RA, and cancer.

Alan Silman commented:

"The results of this study demonstrated that 5-year cancer survival in patients with IP is substantially reduced in comparison with that in the general population, even after adjusting for differences in age, sex, and cancer site, whereas the overall cancer incidence does not seem to be increased."

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