Table 1.

Risk status for specific cancer types in patients with rheumatoid arthritis

Cancer type	Risk in general rheumatoid arthritis	Prognosis	Impact of therapeutics	Recommendations [95]
Overall	10% increase [1]	Worse [13, 16, 17, 25, 89]		Follow national guidelines
Breast	Decreased [1, 8, 14]	Worse [16, 17]	Decreased with TNFi [72]	45–55 years of age: Annual mammography >55 years of age: annual or biannual mammography
Cervical	Likely unchanged [1]			21–29 years of age : Pap smear every 3 years 30–65 years of age: Pap smear and HPV test every 5 years, or Pap smear every 3 years
Gastric	Decreased [3, 6]	Worse [16]
Liver	Decreased [3]	Worse [16]
Colon	Decreased [1, 3, 4]	Worse [16]	NSAIDs may inhibit tumorigenesis [24] TNFi may restore general population level risk [68, 81]	Annual (gFOBT or FIT) or triannual (Multitarget Stool DNA test) stool testing or flexible signmoidoscopy every 5 years Colonoscopy every 10 years or after any positive tests
Lung	Increased [1–3, 25, 26]	Worse [13, 16, 25]	May be increased with MTX [45]	Smoking cessation counseling, as appropriate Consideration of pulmonary imaging risks and benefits
Lymphoproliferative	Increased (2×) [1–5, 11, 28, 29]	Worse [25]	Increased with Aza, CYC [50] Maybe prevented with diligent glucocorticoid use [54] Potential to treat B cell lymphomas with RTX [62, 66]	Control ofrheumatoid arthritis disease activity is important
Multiple myeloma	Likely unchanged [38]
Non-melanoma skin cancer	Likely unchanged [11, 41]	Worse for SCC [16]	May be increased with TNFi [43, 44, 73, 74]	Potential for skin cancer screening, depending on risk factors
Melanoma	Likely unchanged [39]		Maybe increased with MTX [45]
Prostate	Likely unchanged [1]	Worse [17]		Informed decision about prostate-specific antigen screening in men
Renal cell carcinoma	Unclear [13]	Worse [13]

Aza Azathioprine, CYC cyclophosphamide, FIT fecal immunochemical test, HPV human papillomavirus, gFOBT guaiac-based fecal occult blood test, MTX methotrexate, NSAIDs non-steroidal anti-inflammatory drugs, RTX rituximab, SCC squamous cell carcinoma, TNFi tumor necrosis factor inhibitor