Increased total mortality and cancer mortality in men with Dupuytren's disease: A 15-year follow-up study

Abstract

The aim of the present study was to evaluate the mortality rate and causes of death of individuals with Dupuytren's disease. In 1981/82, as part of The Reykjavı́k Study, a general health survey, 1297 males were examined for clinical signs of Dupuytren's disease. Based on the clinical evaluation the participants were classified into three groups: (1) those with no signs of Dupuytren's disease were referred to as the reference cohort; (2) those with palpable nodules in the palmar fascia were classified as having stage 1; and (3) those who had contracted fingers or had been operated on due to contractures were classified as having stage 2 of Dupuytren's disease. In 1997, after a 15- year follow-up period, the mortality rate and causes of death were investigated in relation to the clinical findings from 1981/82. Information about causes of death were obtained from the National Icelandic Death Registry and the Icelandic Cancer Registry. During the follow-up period, 21.5% (225/1048) of the reference cohort were deceased compared to 29.9% (55/184) of those with stage 1 and 47.7% (31/65) of those with stage 2 of Dupuytren's disease. When adjusted for age, smoking habits and other possible confounders, individuals with stage 2 of the disease showed increased total mortality [hazard ratio (HR) = 1.6; 95% CI 1.1–2.4]. Cancer deaths were increased (HR = 1.9; CI 1.0–3.6). In contrast, participants with stage 1 of Dupuytren's disease did not show increased mortality. A moderate but non-significant increase in cancer incidence was observed among individuals with stage 2 of Dupuytren's disease (HR = 1.5; 95% CI 0.9–2.4, P = 0.15). The study showed increased total mortality of individuals with Dupuytren's disease stage 2, where 42% of the excess in mortality could be attributed to cancer deaths.