The five major autoimmune diseases increase the risk of cancer: epidemiological data from a large‐scale cohort study in China

作者：Ziyue Zhou, Huazhen Liu, Yiying Yang, Jingya Zhou, Lidan Zhao, Hua Chen, Yunyun Fei, Wen Zhang, Mengtao Li, Yan Zhao, Xiaofeng Zeng, Fengchun Zhang, Huaxia Yang, Xuan Zhang · 发表于：癌症：英文版 · 年份：2022 · DOI：10.1002/cac2.12283 · 被引用次数：88 · 研究领域：Systemic Sclerosis and Related Diseases、Inflammatory Myopathies and Dermatomyositis、Systemic Lupus Erythematosus Research

BACKGROUND: Cancer incidence and mortality have received critical attention during the long-term management of morbidities in patients with autoimmune diseases (AIDs). This study aimed to investigate and compare the risk of cancer associated with five major AIDs in a large-scale Chinese cohort. METHODS: A total of 8,120 AID patients consecutively admitted to a national tertiary referral center in China were included and followed-up for 38,726.55 patient-years, including those with systemic lupus erythematosus (SLE), rheumatoid arthritis (RA), Sjögren's syndrome (SS), systemic scleroderma (SSc), and idiopathic inflammatory myositis (IIM). Demographic data, cancer incidence, predilecting sites and cancer onset time were recorded and compared among the five AIDs. RESULTS: Four hundred and thirty (5.3%) patients developed cancer. Their median age was 57.5 years and AID duration was 79.8 months. The estimated total standardized incidence ratio (SIR) of cancer in AIDs patients was 3.37, with the highest SIR observed in IIM (4.31), followed by RA (3.99), SSc (3.77), SS (2.88) and SLE (2.58). The increased SIR of cancers in AID patients showed a female predominance (female vs. male: 3.59 vs. 2.77) and younger patient involvement (age <50 vs. ≥50 years: 4.88 vs. 3.04). Patients with SLE had increased SIRs for developing hematologic malignancies and solid tumors located in the urinary bladder, corpus uteri and cervix uteri. Patients with SS had a significantly high SIR for developing n...