Table 3.
Standardized Incidence Ratios from Studies Regarding Cancer Risk Associated with Rheumatoid Arthritis or Inflammatory Polyarthritis
| Article, year (reference) | N cancer events among subjects on TNF inhibitor | Population; mean age or range | Cancer? Exclusions | Stratifying variables | Standardized incidence ratios (95% CI) |
|---|---|---|---|---|---|
|
TNF Inhibitor Only
| |||||
| Askling, 2005 (29) | 67 solid cancers | Sweden; range 16–75+ years | Cancers occurring during first 365 days after entry into cohort are excluded | Age, sex, calendar period | Solid cancers: 0.9 (0.7–1.2) |
|
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| Askling, 2005 (19) | 9 lymphomas 2 leukemias |
Sweden; range 16–75+ years | Cancers occurring during first 365 days after entry into cohort are excluded | Age, sex, calendar period | Lymphoma: 2.9 (1.3 – 5.6) Leukemia: 2.0 (0.2 – 7.3) |
|
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| Geborek, 2005 (22) | 16 all cancers 5 lymphomas |
Sweden; mean 60 years | Previous malignancy | Age, sex, calendar period | All cancers: 1.1 (0.6 – 1.8) Lymphoma: 11.5 (3.7 – 26.9) |
|
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| Mariette, 2010* (32) | 27 lymphomas | France; mean 63 years† | None specified | None specified | Lymphoma: 2.3 (1.6–3.3) |
|
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| Pallavicini, 2010 (33) | 18 all cancers | Italian; mean 56 years | None specified | Age, sex | All cancers: 0.9 (0.6 – 1.5) |
| Milan | 4 lymphomas 5 heamatologic |
Lymphoma: 6.0 (1.6 – 15) Hematologic: 4.1 (1.3 – 9.5) |
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| Varese | 18 all cancers 4 lymphomas 5 heamatologic |
All cancers: 1.1 (0.6 –1.7) Lymphoma: 5.0 (1.3 – 12) Hematologic: 4.1 (1.3 – 9.5) |
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|
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| Wolfe, 2004 (34) | 14 lymphomas | U.S.; mean 68 years | Lymphoma prior to enrollment in database | Age, sex | Lymphoma: 2.9 (1.7 – 4.9) |
|
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|
All RA Patients
| |||||
| Abasolo, 2008 (28) | 25 all cancers 3 non-Hodgkin’s lympomas 4 hematologic |
Spain; mean 61 years | None specified | Age, sex | All cancers: 1.23 (0.78 – 1.85) Lymphoma: 5.4 (1.1 – 15.7) Hematologic: 8.8 (2.4 – 22.6) |
|
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| Ekstrom, 2003 (8) | 8,898 all cancers 535 lymphomas |
Sweden; range 16–60+years | Diagnosis of another rheumatic disease, lost to follow-up, data irregularities, and death | Age, sex, calendar period | All cancers: 1.07 (1.05 – 1.09) Lymphoma: 2.00 (1.83 – 2.17) |
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| Franklin, 2006‡ (30) | 11 lymphomas | United Kingdom; mean 56 years | None specified | Age, sex, calendar period | Lymphoma: 2.4 (1.2 – 4.2) |
|
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| Setoguchi, 2006 (23) | 58 non-Hodgkin’s lymphoma | U.S.; mean 73 years | Cancer diagnosis or HIV | Age, sex | Lymphoma: 2.2 (1.7 – 2.9) |
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| Wolfe, 2007 (25) | 95 lymphomas | U.S.; mean 59 years | Lymphomas prior to enrollment in database | Age, sex | Lymphoma: 1.8 (1.5 – 2.2) |
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| Wolfe, 2007 (24) | 543 all cancers 45 lymphomas 24 leukemias |
U.S.; mean 59 years | All pre 6 month data excluded | Age, sex | All cancer: 1.0 (1.0 – 1.1) Lymphoma: 1.7 (1.3 – 2.2) Leukemia: 1.7 (1.2 – 2.4) |
Lymphoma includes Hodgkin’s and non-Hodgkin’s lymphoma, except where specified. Hematologic malignancy refers to leukemias primarily.
*
We include only the cases and SIR for the rheumatoid arthritis patients.
†
Mean age at cancer diagnosis
‡
Inflammatory polyarthritis cohort and not only rheumatoid arthritis.