RA association with cancer risk clarified | Arthritis Information

Arthritis Res Ther 2008; Advance online publication

Rheumatoid arthritis (RA) is associated with an increased risk for certain cancers, while it decreases the risk for others, results show.

"Because of the immune pathways underlying its pathogenesis and what has generally been an immunosuppressive approach to disease management using traditional disease-modifying anti-rheumatic drugs (DMARDs), the risk of malignancies among RA patients has been of considerable interest," write Samy Suissa (Royal Victoria Hospital, Montreal, Quebec, Canada) and colleagues.

To address these concerns, Suissa and team reviewed all suitable observational studies published between 1990 and 2007 that examined links between RA and malignancy.

Combining data from the 21 relevant studies and comparing it with that from the general population, the authors demonstrated that the risks for lymphoma and lung cancer were significantly increased in patients with RA, with incidence ratios of 2.08 and 1.63, respectively, compared with healthy individuals.

In contrast, patients with RA were significantly less likely to develop colorectal or breast cancer than other individuals, with incidence ratios of 0.77 and 0.84, respectively.

In 13 studies that examined general malignancies, the risk was found to be approximately equal in those with and without RA.

Concluding in the journal Arthritis Research and Therapy, the investigators suggest that "further studies evaluating specific risk factors such as RA management strategies should help provide additional information on the underlying mechanisms for the observed changes in malignancy risk relative to the general population."

In a related editorial, Thorvardur Love and Daniel Solomon from Harvard Medical School in Boston, Massachusetts, USA, agreed on the need for further study, but suggested that the clinical relevance of the current results is unclear. Concluding, Love and Solomon ask whether the findings are significant enough to necessitate separate cancer screening for those with RA.

Journal

This study doesn't take into account what medications RA patients are taking. That would be interesting to see, especially since someone posted they had been on Enbrel 5 years and had developed colon cancer.I really feel that it's the luck of the draw. So far cancer risks statistics seem to be not much different than for the general population. Maybe if you have the gene for a certain type of cancer then taking a biologic might prompt it earlier in your life or not.

Because one person developed colon cancer doesn't mean that that the biologic was the cause. I remember reading that thread and it was inconclusive. I want facts, not generalities when I'm making decisions about medications. One of the reasons why I don't use brand new to the market drugs. I want to be able to read their track record. That's one of the reasons I chose to restart Humira instead of going on to Rituxin or Orencia. Humira had been around longer. That was the best decision I've ever made because I've been in clinical remission for over 12 months. Lindy

I have significant lung cancer history in my family- I fear I will have the same. However no one that died from it had RA either....Cigarette smoking is a risk factor for developing RA.

Perhaps there are more smokers/ex-smokers per person with RA than smokers/ex-smokers per person in the general population.

How can you ever have conclusive evidence of what caused one persons cancer? The cause of cancer isn't even known.If a group has a higher incidence of cancer than the general population, it is statistically significant.[QUOTE=LinB]I really feel that it's the luck of the draw. So far cancer risks statistics seem to be not much different than for the general population. Maybe if you have the gene for a certain type of cancer then taking a biologic might prompt it earlier in your life or not.

[/QUOTE]

Well said........

Statistics is an interesting science.[QUOTE=Gimpy-a-gogo]How can you ever have conclusive evidence of what caused one persons cancer? The cause of cancer isn't even known.[/QUOTE]

Interesting.................

It is well known that smoking and asbestos cause lung cancer. I don't think it is so far fetched that certain drugs will ultimately be found to cause certain types of cancer. So it goes back to statistics..the only way to track such findings. [QUOTE=hessalina]It is well known that smoking and asbestos cause lung cancer. I don't think it is so far fetched that certain drugs will ultimately be found to cause certain types of cancer. So it goes back to statistics..the only way to track such findings.[/QUOTE]

That's exactly what I was thinking!
[QUOTE=hessalina]It is well known that smoking and asbestos cause lung cancer. I don't think it is so far fetched that certain drugs will ultimately be found to cause certain types of cancer. So it goes back to statistics..the only way to track such findings.[/QUOTE]

No disagreement here. I need facts and not speculation.........

When considering this issue it is also important to consider the other side of the risk equation. RA causes chronic inflammation which increases the risk of cardovascular problems and lung disease. So, you also have to weigh the risk of not effectively treating the RA...sometimes a tough and very personal choice.

Alan

[QUOTE=Alan]When considering this issue it is also important to consider the other side of the risk equation. RA causes chronic inflammation which increases the risk of cardovascular problems and lung disease. So, you also have to weigh the risk of not effectively treating the RA...sometimes a tough and very personal choice.

Alan

[/QUOTE]

Well said Alan, very well said
Copyright ArthritisInsight.com