For some time, there has been strong evidence that having rheumatoid arthritis significantly increases one’s risk of dying. Mortality data from another recent study seems to confirm the fact that having inflammatory arthritis and then developing cancer is a bad combination. It appears that if one has inflammatory arthritis and develops cancer, then the risk of dying from that cancer is greater than if one did not have inflammatory arthritis.
Patients with rheumatoid arthritis (RA), a chronic inflammatory autoimmune disease, have a high risk of death from disease — at least double the risk of the general population, studies overwhelmingly show. Evidence has been less clear on whether RA patients are exceptionally vulnerable to dying from cancer.
The first study to investigate whether patients with RA who develop cancer have a decreased rate of survival also examined the impact of rheumatic disease on overall cancer incidence. The study focused on 2,105 patients with recent onset inflammatory polyarthritis (IP). It should be mentioned that over time, a large proportion of new-onset IP cases will evolve into RA
Researchers in the United Kingdom followed the IP patients over a 10-year period to detect the occurrence of cancer. Among the group, they identified 123 cases of cancer for analysis. These cases included bone, lung, breast, prostate, urinary, colon, and brain cancers; cancers of the digestive, respiratory, and central nervous systems; cancers of the blood cells and cancerous tumors; but excluded non-melanotic skin cancers.
Then, they compared these rates with the rates of cancer in the general population from the same geographic area, adjusting for difference in age and sex.
Overall, the incidence of cancer was not increased in the IP subjects compared with the general population. However, the risk of blood cell cancers was increased among the IP sample, a finding researchers expected given the known association between RA and lymphoma.
The study also compared the number of deaths in patients with cancer and inflammatory arthritis with that of cancer patients without a history of inflammatory arthritis. The finding was striking. There was a 40 percent increase in mortality in patients who suffered both IP, or RA, and cancer.
The authors commented that 5-year cancer survival in patients with IP is substantially reduced in comparison with that in the general population, even after adjusting for differences in age, sex, and cancer site, whereas the overall cancer incidence does not seem to be increased.
(Franklin J, Lunt M, Bunn D, Symmons D, Silman A. Influence of Inflammatory Polyarthritis on Cancer Incidence and Survival: Results from a Community-Based Prospective Study. Arthritis Rheum. 2007; 56: 790-798).
Author’s note: Statistics regarding the marked increase in mortality from RA are bad enough. This excess mortality appears to be related to the premature atherosclerosis that is seen in RA. However, this recent study really adds more fuel to the fire. Bottom line: RA is not a benign disease and should be treated as a medical emergency.
Note: This story has been adapted from a news release issued by John Wiley & Sons, Inc..
