Session Information
Date: Monday, October 22, 2018
Title: Spondyloarthritis Including Psoriatic Arthritis – Clinical Poster II: Clinical/Epidemiology Studies
Session Type: ACR Poster Session B
Session Time: 9:00AM-11:00AM
Background/Purpose: Psoriasis (PsO) is a relapsing chronic autoimmune disease of the skin. Up to one-third of patients (pts) also develop inflammatory arthritis, known as psoriatic arthritis (PsA). PsO/PsA, like other forms of chronic inflammatory arthritis, are often associated with complications such as cardiovascular disease and infections. However, data on the risk of cancer in pts with PsO/PsA at population level are limited.
Methods: We created a population-based matched retrospective cohort of PsO/PsA pts diagnosed between 1 January 1997 and 31 December 2012 using administrative health data from British Columbia, Canada. We identified all incident cases of PsO/PsA and an equal number of controls matched on sex, age and calendar year. PsO/PsA cases met ≥1 of the following: 1 diagnostic code for PsO/PsA by a rheumatologist/dermatologist; ≥2 diagnostic codes for PsO/PsA, ≥2 months apart in a 2-year period by a non-rheumatologist/dermatologist; or ≥1 hospitalization with diagnostic code for PsO/PsA. We evaluated incident cancers during follow-up from the Cancer Registry in both cohorts. Adjusted risk of cancers was estimated using a generalized estimating equation extension of multivariate Poisson regression models.
Results: We identified 81,568 incident cases of PsO/PsA (mean age 48.5 years [SD=17.8], 51.5% female). Individuals with PsO/PsA were at significantly higher risk of being diagnosed with 8/41 types of cancer examined, including eye and orbit (4 fold), female genital (3 fold), non-melanoma skin (2 fold), prostate (males; 1.1 fold) (Table). Incidence of rectum and colon cancer was lower among PsO/PsA pts relative to the non-PsO/PsA cohort (Table)
Conclusion: This general population-based study demonstrates that pts with PsO/PsA have an increased risk of several types of cancer, and a decreased risk of rectum and colon cancer. This association highlights the need to further explore potential risk factors and pathways that contribute to these complications.
|
Outcome |
PsO/PsA events |
Non-PsO/PsA events |
PsO/PsA follow-up (PY) |
Non-PsO/PsA follow-up (PY) |
PsO/PsA IR (per 100,000 PY) |
Non-PsO/PsA IR (per 100,000 PY) |
IRR |
|
Eye and orbit |
13 |
<5 |
623,843.5 |
<5 |
2.08 |
– |
4.25 |
|
Female genital other than cervix uteri, corpus uteri and ovary |
55 |
21 |
623,625.8 |
611,542.1 |
8.81 |
3.43 |
2.57 |
|
Other urinary |
31 |
16 |
623,818.6 |
611,585.4 |
4.97 |
2.62 |
1.90 |
|
Non-melanoma skin |
401 |
217 |
621,233.8 |
610,223.9 |
64.54 |
35.56 |
1.82 |
|
Lung |
705 |
589 |
622,877.2 |
610,834.8 |
113.18 |
96.42 |
1.17 |
|
Prostate |
760 |
664 |
620,065.8 |
608,124.9 |
122.57 |
109.19 |
1.12 |
|
Melanoma |
218 |
200 |
622,791 |
610,672.1 |
35.0037 |
32.7508 |
1.07 |
|
Colon |
286 |
332 |
622,845.1 |
610,410.5 |
45.91 |
54.39 |
0.84 |
|
Rectum |
157 |
194 |
623,196.9 |
610,811.7 |
25.19 |
31.76 |
0.79 |
|
IRR=incidence rate ratio; PY=patient years |
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To cite this abstract in AMA style:
Tan J, Avina-Zubieta JA, Dominique A, Tavakoli H, Simon TA. Risk of Cancer in Patients with Psoriasis/Psoriatic Arthritis: A Population-Based Study in the Province of British Columbia [abstract]. Arthritis Rheumatol. 2018; 70 (suppl 9). https://acrabstracts.org/abstract/risk-of-cancer-in-patients-with-psoriasis-psoriatic-arthritis-a-population-based-study-in-the-province-of-british-columbia/. Accessed .« Back to 2018 ACR/ARHP Annual Meeting
ACR Meeting Abstracts - https://acrabstracts.org/abstract/risk-of-cancer-in-patients-with-psoriasis-psoriatic-arthritis-a-population-based-study-in-the-province-of-british-columbia/