조미희 (성균관대학교 의과대학, 강북삼성병원) | 한빛사논문 > 한빛사

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조미희Mi Hee Cho

성균관대학교 의과대학, 강북삼성병원

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J. Thorac. Oncol., Oct 12 2023, S1556-0864(23)02293-1 | https://doi.org/10.1016/j.jtho.2023.10.006 Rheumatoid arthritis and risk of lung cancer: a nationwide cohort study

Mi Hee Cho MD, PhD ^a,∗, Jong Ho Cho MD, PhD ^b,∗, Yeonghee Eun MD ^c, Kyungdo Han PhD ^d, Jinhyoung Jung PhD ^e, In Young Cho MD ^f, Jung Eun Yoo MD, PhD ^g, Hyun Lee MD ^h, Hyungjin Kim MD, PhD ^i,j, Seong Yong Park MD ^b, Dong Wook Shin MD, DrPH, MBA ^f,k

^aSamsung C&T Medical Clinic, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea

^bDepartment of Thoracic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea

^cDivision of Rheumatology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea

^dDepartment of Statistics and Actuarial Science, Soongsil University, Seoul, Republic of Korea

^eDepartment of Medical Statistics, College of Medicine, Catholic University of Korea, Seoul, Republic of Korea

^fDepartment of Family Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea

^gDepartment of Family Medicine, Healthcare System Gangnam Center, Seoul National University Hospital, Seoul, Republic of Korea

^hDivision of Pulmonary Medicine and Allergy, Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Republic of Korea

ⁱDepartment of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea

^jDepartment of Medical Humanities, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea

^kDepartment of Clinical Research Design & Evaluation, Samsung Advanced Institute for Health Science & Technology (SAIHST), Sungkyunkwan University, Seoul, Republic of Korea

^∗Contributed equally as first authors

Corresponding Authors: Dong Wook Shin, MD, DrPH, MBA

Abstract

Introduction: There has been increasing interest in the risk of lung cancer related to rheumatoid arthritis (RA). We investigated the association between RA and the risk of lung cancer with consideration of key confounding factors, including RA serostatus and smoking status.

Methods: Using a nationwide database, we identified 51,899 patients with newly diagnosed RA between 2010 and 2017, which were matched by sex and age at a 1:5 ratio with 259,495 non-RA population. The association of lung cancer and RA was investigated using Cox regression analyses. Stratified analyses by smoking status, sex, age, and comorbidity of interstitial lung disease (ILD) were conducted using the same Cox modeling.

Results: During 4.5 years of follow-up, the adjusted hazard ratio of lung cancer in the RA patients was 1.49 (95% confidence interval, 1.34-1.66). Compared to the seronegative RA patients, an increased risk of lung cancer was not significant in the seropositive RA patients. In the stratified analyses, the increased risk of lung cancer was more prominent in current or previously heavy smokers with RA (interaction p-value 0.046) and male patients (interaction p-value <0.001), while there was no significant effect associated with age or ILD status.

Conclusion: Patients with RA showed an increased risk of lung cancer compared to the non-RA group and the risk did not differ by RA serostatus. There is a need for increased awareness of smoking cessation and potentially for regular lung cancer screening with proper risk stratification in RA patients.

논문정보

형식Research article
게재일2023년 10월 (BRIC 등록일 2023-10-16)
연구진국내 연구진
분야 의약학 > 종양의학

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