Background/Purpose: The aim of this study is to determine the risk of overall malignancy and site-specific cancer in ankylosing spondylitis (AS) patients compared with patients without AS in Korea.

Methods: The study utilized the National Health Information Database managed by National Health Insurance Service in Korea. The data from national health screening programs, data related to medical care institutions and a registry of cancer and rare/severe intractable diseases were also included. Patients diagnosed as AS (International Classification of Diseases, 10^th revision codes M45.0 and code V140 used in Korea for severe intractable diseases) between 2010 and 2015 were extracted. Of these, patients with a history of cancer during the washout period from 2008 to 2009 were excluded. For the control cohort, an age- and sex-matched population without AS was randomly extracted at a control-to-case ratio of 3:1. The incidence rates for overall and specific cancers were calculated per 1000 person-years. Multivariate Cox regression model was used to evaluate the risk for malignancies. Results presented as hazard ratios (HRs) with 95% confidence intervals (CIs).

Results: A total of 15,979 patients with AS and 47,937 matched controls were included for analysis. The prevalence of diabetes mellitus, hypertension and dyslipidemia which are well known risk factors for cancer were statistically high in AS patients (5.76% vs 4.84%, 16.66% vs 12.34%, 11.3% vs 7.99%, respectively) [ p < 0.0001, p< 0.001 and p < 0.0001. respectively]). Cancer was diagnosed in 311 patients (1.95%) and 931 patients (1.94%) in the AS group and age- and sex-matched control group, respectively. After adjusting age, sex, diabetes mellitus, hypertension, dyslipidemia, regions and income status, patients with AS showed higher risk for lymphoma (HR, 3.052; 95% CI, 1.446-6.446), leukemia (HR, 2.322; 95% CI, 0.911-5.914) and multiple myeloma (HR 2.829; 95% CI, 1.16-6.901). The risk of solid cancers was not different between the two groups.

Conclusion: In this nationwide population-based study in Korea, AS patients were associated with increased risk of hematologic malignancies. Further research is needed to determine the relationship between AS and these malignancies.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/cancer-risk-in-patients-with-ankylosing-spondylitis-a-nationwide-population-based-dynamic-cohort-study-from-korea/