Abstract
The association between rheumatoid arthritis (RA) and malignancies has received increased attention in recent years. Reports suggesting that tumor necrosis factor blockers might elevate the risk of malignancy in RA patients have prompted researchers to look at the incidence of malignancies in all RA patients. In a recent issue of Arthritis Research & Therapy, Smitten and colleagues suggest that previous reports of a standardized incidence ratio close to one for malignancies in RA may reflect an increased risk for some site-specific malignancies and a reduced risk for others. Here we discuss these findings and suggest what issues could be addressed in future studies.
Highlights
In a recent issue of Arthritis Research & Therapy, Smitten and colleagues [1] reported the results of a meta-analysis of studies looking at the relative risk of malignancies in rheumatoid arthritis (RA) patients compared to the general population, as expressed by a standardized incidence ratio (SIR)
While their finding of a SIR of 1.05 for all malignancies in this group supports previous studies, they report SIRs for lymphoma of 2.08 and lung cancer of 1.63, and decreased relative risks for colorectal cancer of 0.77 and breast cancer of 0.84. These results suggest that the previously reported SIR close to 1 for all malignancies in RA patients [2] may be explained in part by an increased relative risk for some site-specific malignancies and a reduction in the relative risk for others
When attempting to separate the reported association between malignancy and RA, the subject of the review by Smitten and colleagues, from the association reported for tumor necrosis factor (TNF) blockers [3], it is important to avoid bias introduced by different patterns of drug use
Summary
In a recent issue of Arthritis Research & Therapy, Smitten and colleagues [1] reported the results of a meta-analysis of studies looking at the relative risk of malignancies in rheumatoid arthritis (RA) patients compared to the general population, as expressed by a standardized incidence ratio (SIR). While their finding of a SIR of 1.05 for all malignancies in this group supports previous studies, they report SIRs for lymphoma of 2.08 and lung cancer of 1.63, and decreased relative risks for colorectal cancer of 0.77 and breast cancer of 0.84.
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