患有类风湿性关节炎的患者癌症风险与普通人群:国家索赔数据库队列研究
Maxime Beydon1, Sandrine Pinto1, Yann De Rycke2
1Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, F75013, Paris, France.
The Lancet regional health. Europe
|November 13, 2023
概括
患有类风湿性关节炎的患者面临癌症风险增加,特别是肺癌和膀癌. 然而,与普通人群相比,乳腺癌和胰腺癌的风险较低.
科学领域:
- 类风湿病学 类风湿病学
- 在瘤学瘤学.
- 流行病学 流行病学
背景情况:
- 以前的研究表明,类风湿性关节炎 (RA) 患者的癌症风险增加了10-30%.
- 最近的治疗进展可能会通过影响疾病活动或免疫反应来改变这种风险.
- 关于RA患者罕见癌症的数据仍然有限.
研究的目的:
- 为了比较治疗的RA患者与普通人群的癌症风险.
- 分析RA患者的整体癌症风险和局部特定风险.
- 根据特定的治疗暴露量来评估癌症风险.
主要方法:
- 全国基于人口的研究,使用法国国家健康声明数据库 (SNDS).
- 从2010年1月1日至2020年12月31日期间收集的数据.
- 标准化发病率 (SIR) 用法国基于人口的癌症登记册网络 (FRANCIM) 进行计算.
主要成果:
- 257,074名RA患者贡献了2,098,238人的年份.
- 总体癌症风险增加 (SIR 1.20).
- 肺部 (SIR 1.41),膀 (SIR 2.38),子宫 (SIR 1.80),前列腺 (SIR 1.08),黑色素瘤 (SIR 1.37),扩散大B细胞淋巴瘤 (SIR 1.79),多发性骨髓瘤 (SIR 1.42) 和霍奇金淋巴瘤 (SIR 2.73) 的风险增加.
- 胰腺癌 (SIR 0.90),乳腺癌 (SIR 0.91),子宫内膜癌 (SIR 0.77) 的风险较低.
- 利图西马布治疗与最高的癌症风险有关.
- 随着时间的推移,人们观察到非霍奇金淋巴瘤风险下降的趋势.
结论:
- 与一般人群相比,接受治疗的RA患者的整体癌症和特定部位的风险更高.
- 乳腺癌,胰腺癌和子宫内膜癌的风险在RA患者中明显较低.
- 利图西马布治疗可能与RA患者癌症风险增加有关.
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