Rheumatoid arthritis and risk of lung cancer: a nationwide cohort study
Menée en Corée à l'aide de données portant sur 51 899 personnes souffrant de polyarthrite rhumatoïde (durée de suivi : 4,5 ans), cette étude analyse le risque de cancer du poumon associé à cette maladie, en fonction du sexe, du statut tabagique et de l'âge
Introduction: There has been increasing interest in the risk of lung cancer related to rheumatoid arthritis (RA). We investigated the association between RA and the risk of lung cancer with consideration of key confounding factors, including RA serostatus and smoking status. Methods: Using a nationwide database, we identified 51,899 patients with newly diagnosed RA between 2010 and 2017, which were matched by sex and age at a 1:5 ratio with 259,495 non-RA population. The association of lung cancer and RA was investigated using Cox regression analyses. Stratified analyses by smoking status, sex, age, and comorbidity of interstitial lung disease (ILD) were conducted using the same Cox modeling. Results: During 4.5 years of follow-up, the adjusted hazard ratio of lung cancer in the RA patients was 1.49 (95% confidence interval, 1.34–1.66). Compared to the seronegative RA patients, an increased risk of lung cancer was not significant in the seropositive RA patients. In the stratified analyses, the increased risk of lung cancer was more prominent in current or previously heavy smokers with RA (interaction p-value 0.046) and male patients (interaction p-value <0.001), while there was no significant effect associated with age or ILD status. Conclusion: Patients with RA showed an increased risk of lung cancer compared to the non-RA group and the risk did not differ by RA serostatus. There is a need for increased awareness of smoking cessation and potentially for regular lung cancer screening with proper risk stratification in RA patients.