AI Article Synopsis

  • - The study aimed to assess how common lung cancer is among patients with rheumatoid arthritis (RA) and identify factors that predict its occurrence.
  • - Out of 771 RA patients followed for an average of 9.3 years, different lung conditions showed varied lung cancer incidence rates, with CPFE patients at the highest risk (47.8 cases per 1,000 patient-years).
  • - Findings suggest that RA patients with smoking history and pulmonary complications, particularly CPFE, should be closely monitored for lung cancer risk.

Article Abstract

Objective: To determine the incidence and predictive factors of lung cancer in rheumatoid arthritis (RA).

Methods: We conducted a retrospective follow-up study of patients who were diagnosed with RA at our institution between April 2001 and December 2022. Pulmonary complications were evaluated using high-resolution computed tomography at RA diagnosis. Patients were followed until the diagnosis of lung cancer, diagnosis of other malignancies, death, loss to follow-up, or the end of the study.

Results: Among 771 RA patients, 3.5% were diagnosed with combined pulmonary fibrosis and emphysema (CPFE), 4.9% with interstitial lung disease (ILD) alone, and 6.0% with emphysema alone. During follow-up (mean of 9.3 years), the crude incidence rates of lung cancer per 1,000 patient-years were 2.9 in all patients, 47.8 in CPFE patients, 10.5 in ILD patients, 11.9 in emphysema patients, and 0.8 in patients without these complications. The standardized incidence ratios (95% confidence intervals [CI]) compared with the general population were 2.53 (1.29-3.77) for male patients and 0.89 (0.57-1.16) for female patients. In Fine-Gray regression analysis, adjusted hazard ratios (95% CI) of lung cancer were 13.48 (3.14-57.85) for CPFE, 6.42 (1.42-29.09) for ILD alone, and 4.65 (1.18-18.30) for emphysema alone versus without these complications, and 1.02 (1.01-1.04) per additional 1 pack-year for smoking history. These factors were not associated with the risk of other malignancies.

Conclusion: Close monitoring of lung cancer is needed for RA patients with smoking history and pulmonary complications, especially CPFE.

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Source
http://dx.doi.org/10.1093/mr/roae084DOI Listing

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