Abstract
Background: The association between giant cell arteritis (GCA) and malignancies had been widely investigated with studies reporting conflicting results. Therefore, in this study, we aimed to investigate this association using a large nationwide electronic database. Methods: This study was designed as a retrospective cohort study including GCA patients first diagnosed between 2002–2017 and age, sex and enrollment time-matched controls. Follow-up began at the date of first GCA-diagnosis and continued until first diagnosis of malignancy, death or end of study follow-up. Results: The study enrolled 7213 GCA patients and 32,987 age- and sex-matched controls. The mean age of GCA diagnosis was 72.3 (SD 9.9) years and 69.1% were women. During the follow-up period, 659 (9.1%) of GCA patients were diagnosed with solid malignancies and 144 (2.0%) were diagnosed with hematologic malignancies. In cox-multivariate-analysis the risk of solid- malignancies (HR = 1.12 [95%CI: 1.02–1.22]), specifically renal neoplasms (HR = 1.60 [95%CI: 1.15–2.23]) and sarcomas (HR = 2.14 [95%CI: 1.41–3.24]), and the risk of hematologic malignancies (HR = 2.02 [95%CI: 1.66–2.47]), specifically acute leukemias (HR = 1.81 [95%CI: 1.06–3.07]), chronic leukemias (HR = 1.82 [95%CI: 1.19–2.77]), Hodgkin’s lymphomas (HR = 2.42 [95%CI: 1.12–5.20]), non-Hodgkin’s-lymphomas (HR = 1.66: [95%CI 1.21–2.29]) and multiple myeloma(HR = 2.40 [95%CI: 1.63–3.53]) were significantly increased in GCA patients compared to controls. Older age at GCA-diagnosis (HR = 1.36 [95%CI: 1.25–1.47]), male-gender (HR = 1.46 [95%CI: 1.24–1.72]), smoking (HR = 1.25 [95%CI: 1.04–1.51]) and medium-high socioeconomic status (HR = 1.27 [95%CI: 1.07–1.50]) were independently associated with solid malignancy while age (HR = 1.47 [95%CI: 1.22–1.77]) and male-gender (HR = 1.61 [95%CI: 1.14–2.29]) alone were independently associated with hematologic- malignancies. Conclusion: our study demonstrated higher incidence of hematologic and solid malignancies in GCA patients. Specifically, leukemia, lymphoma, multiple myeloma, kidney malignancies, and sarcomas. Age and male gender were independent risk factors for hematological malignancies among GCA patients, while for solid malignancies, smoking and SES were risk factors as well.
Highlights
Giant cell arteritis (GCA) is an inflammatory disorder of large and medium-sized arteries that preferentially involves branches of the external carotid artery [1]
The risk of gastric cancer (HR 0.61 [95%confidence interval (CI) 0.37–0.98]) was significantly lower in giant cell arteritis (GCA) patients compared to controls (Table 3)
95% confidence level. ** Statistical significance at 99% confidence level. In this large nationwide population-based study, we found an increased risk for sarcomas, kidney malignancies, and overall solid malignancies in GCA patients compared to controls
Summary
Giant cell arteritis (GCA) is an inflammatory disorder of large and medium-sized arteries that preferentially involves branches of the external carotid artery [1]. Epidemiologic studies demonstrated disease predominance among elderly females and individuals of Northern European ancestry. The etiopathogenesis of GCA is uncertain, with evidence suggesting roles played by certain genetic backgrounds as well as immunosenescence as driving forces in the disease pathogenesis [2,3]. The association between chronic inflammation and tumorigenesis had been widely investigated. Several rheumatologic diseases were associated with increased risk of malignancy. The association between giant cell arteritis (GCA) and malignancies had been widely investigated with studies reporting conflicting results. In this study, we aimed to investigate this association using a large nationwide electronic database. GCA-diagnosis and continued until first diagnosis of malignancy, death or end of study follow-up
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
