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Association Between Rheumatoid Arthritis and Survival After Cancer: A Systematic Literature Review and Meta-analysis
Joshua J Hsieh1, Hemant Khandelia2, Avneet Kaur3
1Lakeside School, Seattle, Washington.
ACR Open Rheumatology
|July 23, 2026
Summary
Patients with rheumatoid arthritis (RA) and cancer generally have similar survival rates to those with cancer alone. However, RA significantly worsens survival for lung, hematologic, and breast cancer patients.
Area of Science:
- Rheumatology and Oncology
- Epidemiology
- Clinical Research
Background:
- Limited and conflicting evidence exists regarding cancer outcomes in patients with rheumatoid arthritis (RA).
- Understanding the impact of RA on cancer survival is crucial for patient management.
Purpose of the Study:
- To systematically review and evaluate the association between rheumatoid arthritis (RA) and overall survival in cancer patients.
- To synthesize existing data on mortality differences between cancer patients with and without RA.
Main Methods:
- A comprehensive literature search identified observational studies on mortality in RA and cancer patients.
- Study quality was assessed using the Newcastle-Ottawa Scale.
- Mortality estimates were pooled using inverse variance weighting and random effects models.
Main Results:
- Twenty studies included 59,299 patients with RA and cancer, and 1,761,008 with cancer alone.
- Overall, RA did not significantly impact mortality in cancer patients (HR 1.13; 95% CI 0.90-1.42).
- Significantly worse survival was observed for RA patients with lung (HR 1.22), hematologic (HR 1.20), and breast cancer (HR 1.41).
Conclusions:
- Patients with RA and cancer do not generally have poorer survival compared to cancer patients without RA.
- Survival is significantly reduced for RA patients with lung, hematologic, or breast malignancies.
- Further prospective research is needed to understand mechanisms and improve cancer care in RA patients.
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