A higher incidence of hematologic and solid malignancies was found among patients with giant cell arteritis (GCA), specifically among those with lymphoma, leukemia, multiple myeloma, sarcomas, and kidney cancers, according to study results published in International Journal of Environmental Research and Public Health.
Researchers sought to explore the association between GCA and the development of certain malignancies.
A large, population-based, retrospective cohort study was conducted in Israel, using the Clalit Healthcare Services nationwide electronic database. Patients with GCA who were initially diagnosed with GCA between 2002 and 2017 were enrolled in the study, along with age, sex, and enrollment time-matched control participants. Follow-up was on the date of initial diagnosis of GCA.
A total of 7213 patients with GCA and 32,987 sex- and age-matched control participants were enrolled in the current study. Mean patient age at GCA diagnosis was 72.3±9.9 years; 69.1% of the patients were women.
Patients with GCA compared with control participants had significantly higher rates of smoking (24.8% vs 19.8%, respectively; P <.001) and obesity (24.2% vs 19.8%, respectively; P <.001). During follow-up, 9.1% (n=659) of patients with GCA were diagnosed with a solid malignancy and 2.0% (n=144) of patients were diagnosed with a hematologic malignancy.
Baseline rates of hematologic malignancies were significantly higher among patients with GCA compared with control participants (1.9% vs 1.2%, respectively; P <.001), specifically for those with multiple myeloma (0.4% vs 0.2%, respectively; P <.001), non-Hodgkin lymphoma (0.9% vs 0.6%, respectively; P <.001), Hodgkin lymphoma (0.3% vs 0.1%, respectively; P <.005), and prostate cancer (5.5% vs 4.4%, respectively; P <.05).
With regard to incident cases of cancers that were first diagnosed following enrollment, among patients with GCA vs control participants, the rates of solid cancers were higher (9.1% vs 8.4%, respectively; P <.05), specifically of the kidney (0.7% vs 0.4%, respectively; P <.05) and sarcoma (0.4% vs 0.2%, respectively; P <.001). Rates of hematologic cancers (2.0% vs 1.0%, respectively; P <.001), specifically acute leukemia (0.3% vs 0.1%, respectively; P <.05), chronic leukemia (0.4% vs 0.2%, respectively; P <.01), multiple myeloma (0.5% vs 0.2%, respectively; P <.001), non-Hodgkin lymphoma (0.7% vs 0.4%, respectively; P <.005), and Hodgkin lymphoma (0.2% vs 0.1%, respectively; P <.05), were higher among patients with GCA than among control participants.
Further, older age at diagnosis of GCA (hazard ratio [HR], 1.36; 95% CI, 1.25-1.47), male sex (HR, 1.46; 95% CI, 1.24-1.72), medium to high socioeconomic status (HR, 1.27; 95% CI, 1.07-1.50), and smoking (HR, 1.25; 95% CI, 1.04-1.51) were all independently associated with the occurrence of solid malignancies. Age (HR, 1.47; 95% CI, 1.22-1.77) and male sex (HR, 1.61; 95% CI, 1.14-2.29) were both independently associated with the occurrence of hematologic malignancies.
Researchers concluded that the results of this study were consistent with the risk factors for malignancy reported in the general population, with this research group being the first to report that these findings are observed among patients with GCA as well.
Dar L, Ben-Shabat N, Tiosano S, et al. The incidence and predictors of solid- and hematological malignancies in patients with giant cell arteritis: a large real-world database study. Int J Environ Res Public Health. 2021;18(14):7595. doi:10.3390/ijerph18147595