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Increased risk of cancer in patients with mixed connective tissue disease: a population-based cohort study in Korea
Su Jin Choi1, Sojeong Park2, Minae Park2
1Division of Rheumatology, Department of Internal Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, 25, Daehakbyeongwon-ro, Dong-gu, Ulsan, 44033, South Korea.
Introduction:
We conducted a nationwide, population-based cohort study to evaluate the risk of cancer in Korean patients with mixed connective tissue disease (MCTD) compared with the corresponding risk in the general population.
Methods:
Using the Korean National Health Insurance Service data, we identified 2,094 patients with newly diagnosed MCTD between 2004 and 2020 (16,409 person-years). Standardized incidence ratios (SIRs) were calculated to compare the overall and site-specific cancer risks between patients with MCTD and the age- and sex-matched general population.
Results:
The overall risk of cancer was significantly higher in patients with MCTD than in the general population (SIR 2.61, 95% confidence interval [CI] 2.27-2.99). For site-specific cancers, both the risks of solid (SIR 2.46, 95% CI 2.12-2.84) and haematologic (SIR 6.81, 95% CI 4.36-10.13) cancers were elevated in patients with MCTD compared with the general population. Among solid cancers, increased risks were observed for several sites, including the lung, ovary, liver, pancreas, cervix, gallbladder/biliary tract, prostate, bladder, and oesophagus. Regarding haematologic cancers, multiple myeloma, myelodysplastic syndrome, and non-Hodgkin lymphoma showed increased risks. The relative cancer risk was highest in patients aged 20-39 years (SIR 4.04, 95% CI 2.90-5.48) and during the first year after MCTD diagnosis (SIR 3.77, 95% CI 2.70-5.11).
Conclusions:
Patients with MCTD have an increased cancer risk, particularly haematologic cancer, compared with the general population. The cancer risk was particularly elevated in younger patients and during the first year after MCTD diagnosis. Key Points • Patients with MCTD have a higher overall risk of cancer, particularly haematologic cancer. • Cancer risk is particularly elevated during the first year after MCTD diagnosis, and clinicians should not overlook the possibility of cancer in younger patients with suggestive clinical features.
