TY - JOUR

T1 - Risk of Cancer Among Sarcoidosis Patients With Biopsy-verified Nonnecrotizing Granulomatous Inflammation

T2 - Population-based Cohort Study

AU - Faurschou, Mikkel

AU - Omland, Lars H.

AU - Obel, Niels

AU - Lindhardsen, Jesper

AU - Baslund, Bo

N1 - Funding Information: This work was supported by the Board of Research at the Copenhagen University Hospital, Rigshospitalet, Denmark (MF). 1M. Faurschou, MD, DMSci, J. Lindhardsen, MD, PhD, B. Baslund, MD, PhD, Copenhagen Lupus and Vasculitis Clinic, Center for Rheumatology and Spine Diseases; 2L.H. Omland, MD, DMSci, N. Obel, Professor, MD, DMSci, Department of Infectious Diseases, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark. The authors declare no conflicts of interest relevant to this article. Address correspondence to Dr. M. Faurschou, Copenhagen Lupus and Vasculitis Clinic, Center for Rheumatology and Spine Diseases, Copenhagen University Hospital, Rigshospitalet, 9 Blegdamsvej, Copenhagen, Denmark. Email: mikkel.faurschou@regionh.dk. Accepted for publication November 2, 2021. Publisher Copyright: © 2022 Journal of Rheumatology. All rights reserved.

PY - 2022

Y1 - 2022

N2 - Objective. To assess the long-term risk of hematologic cancers, invasive solid tumors, and nonmelanoma skin cancer (NMSC) among sarcoidosis patients with biopsy-verified nonnecrotizing granulomatous inflammation. Methods. We used Danish administrative registers with nationwide coverage to construct a cohort of 3892 patients with sarcoidosis and an age- and sex-matched comparison cohort of 38,920 population controls. For all patients, a biopsy demonstrating nonnecrotizing granulomatous inflammation had been obtained from the lower respiratory tract at the time of diagnosis. Study outcome was time to diagnosis of cancer. Follow-up began at time of sarcoidosis diagnosis and continued for up to 10 years. We calculated hazard ratios (HRs) as estimates of the cancer risk among the patients with sarcoidosis relative to that among the population controls and used cumulative incidence functions to calculate absolute 10-year risk estimates. Results. We observed an increased long-term risk of hematologic cancers (HR during the first 2 years of follow-up: 2.71 [95% CI 1.18–6.25]; HR after > 2 years of follow-up: 2.12 [95% CI 1.29–3.47]) and NMSC (HR after > 2 years of follow-up: 1.82 [95% CI 1.43–2.32]) among the patients with sarcoidosis. An increased risk of invasive solid tumors was only observed during the first 2 years (HR 1.55, 95% CI 1.18–2.04). Compared with the population controls, the patients with sarcoidosis had an increased absolute 10-year risk of hematologic cancers (risk difference 0.56%, 95% CI 0.11–1.01%) and NMSC (risk difference 1.58%, 95% CI 0.70–2.47%). Conclusion. Sarcoidosis patients with biopsy-verified nonnecrotizing granulomatous inflammation have an increased long-term risk of hematologic cancers and NMSC compared with the general population.

AB - Objective. To assess the long-term risk of hematologic cancers, invasive solid tumors, and nonmelanoma skin cancer (NMSC) among sarcoidosis patients with biopsy-verified nonnecrotizing granulomatous inflammation. Methods. We used Danish administrative registers with nationwide coverage to construct a cohort of 3892 patients with sarcoidosis and an age- and sex-matched comparison cohort of 38,920 population controls. For all patients, a biopsy demonstrating nonnecrotizing granulomatous inflammation had been obtained from the lower respiratory tract at the time of diagnosis. Study outcome was time to diagnosis of cancer. Follow-up began at time of sarcoidosis diagnosis and continued for up to 10 years. We calculated hazard ratios (HRs) as estimates of the cancer risk among the patients with sarcoidosis relative to that among the population controls and used cumulative incidence functions to calculate absolute 10-year risk estimates. Results. We observed an increased long-term risk of hematologic cancers (HR during the first 2 years of follow-up: 2.71 [95% CI 1.18–6.25]; HR after > 2 years of follow-up: 2.12 [95% CI 1.29–3.47]) and NMSC (HR after > 2 years of follow-up: 1.82 [95% CI 1.43–2.32]) among the patients with sarcoidosis. An increased risk of invasive solid tumors was only observed during the first 2 years (HR 1.55, 95% CI 1.18–2.04). Compared with the population controls, the patients with sarcoidosis had an increased absolute 10-year risk of hematologic cancers (risk difference 0.56%, 95% CI 0.11–1.01%) and NMSC (risk difference 1.58%, 95% CI 0.70–2.47%). Conclusion. Sarcoidosis patients with biopsy-verified nonnecrotizing granulomatous inflammation have an increased long-term risk of hematologic cancers and NMSC compared with the general population.

KW - Cancer

KW - Risk

KW - Sarcoidosis

U2 - 10.3899/jrheum.210588

DO - 10.3899/jrheum.210588

M3 - Journal article

C2 - 34782449

AN - SCOPUS:85123969067

VL - 49

SP - 186

EP - 191

JO - Journal of Rheumatology

JF - Journal of Rheumatology

SN - 0315-162X

IS - 2

ER -