Chapter 2 - Rheumatoid Arthritis and Cancer

Abstract

Rheumatoid arthritis (RA) is a chronic systemic inflammatory disease characterized by proliferative synovitis of diarthrodial joints, serositis, and lymphocytic infiltration in various tissues; vasculitis of small vessels; and the production of anti-immunoglobulin autoantibodies (rheumatoid factor). The etiology of the disease remains unknown. However, environmental and immunogenetic factors may have a role in the development of the disease. The management of RA includes the use of nonsteroidal anti-inflammatory drugs, steroids, and the disease modifying anti-rheumatic drugs (DMARDs). The chapter reviews various case reports to show the prevalence of cancer in RA and the risk of cancer in RA patients as compared to the general population. The chapter describes the specific cancers that are most commonly linked with RA. RA is associated with an increased risk of lymph proliferative cancers including lymphoma, leukemia, and myeloma. Several studies report the site-specific risks for solid tumors among patients with RA. The chapter discusses the possible causes for the increased risk of malignancies among patients with RA : the use of cytotoxic and immunosuppressive agents, infectious agents, genetic susceptibility, and immunological abnormalities.