Ankylosing spondylitis and the risk of cancer
- Chih‑Cheng Chang
- Cheng‑Wei Chang
- Phung‑Anh Alex Nguyen
- Tzu‑Hao Chang
- Ya‑Ling Shih
- Wen‑Ying Chang
- Jorng‑Tzong Horng
- Oscar Kuang‑Sheng Lee
- Jennifer Hui‑Chun Ho
Affiliations: Department of Internal Medicine, College of Medicine, Taipei Medical University, Taipei 110, Taiwan, R.O.C., Department of Information Management, Hsing Wu University, New Taipei 244, Taiwan, R.O.C., College of Medical Science & Technology, Taipei Medical University, Taipei 110, Taiwan, R.O.C., Graduate Institute of Biomedical Informatics, Taipei Medical University, Taipei 110, Taiwan, R.O.C., Department of Nursing, En Chu Kong Hospital, New Taipei 237, Taiwan, R.O.C., Department of Electrical Engineering, National Cheng‑Kung University, Tainan 701, Taiwan, R.O.C., Department of Biomedical Informatics, Asia University, Taichung 413, Taiwan, R.O.C., Institute of Clinical Medicine, National Yang‑Ming University, Taipei 112, Taiwan, R.O.C., Center for Stem Cell Research and Clinical Trial, Wan Fang Hospital, Taipei Medical University, Taipei 116, Taiwan, R.O.C.
- Published online on: June 9, 2017 https://doi.org/10.3892/ol.2017.6368
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Cancer is a multifactorial disease, and imbalances of the immune response and sex‑associated features are considered risk factors for certain types of cancer. The present study aimed to assess whether ankylosing spondylitis (AS), an immune disorder that predominantly affects young adult men, is associated with an increased risk of cancer. Using the Taiwan National Health Insurance Research Database, a cohort of patients diagnosed with AS between 2000 and 2008 who had no history of cancer prior to enrollment was established (n=5,452). Age‑ and sex‑matched patients without AS served as controls (n=21,808). The results revealed that the overall incidence of cancer was elevated in patients with AS [standardized incidence ratio (SIR), 1.15; 95% confidence interval (CI), 1.03‑1.27]. AS carried an increased risk of hematological malignancy in both sexes, colon cancer in females and bone and prostate cancer in males. Young patients with AS (≤35 years) and patients with a Charlson comorbidity index (CCI) ≥2 experienced a higher incidence of cancer (males, SIR 1.92, and 95% CI 1.04‑3.26; females, SIR 2.00 and 95% CI 1.46‑5.50). The cancer risk was increased during the first 3 years following the diagnosis of AS (SIR 1.49, 95% CI 1.29‑1.71), and overall cancer‑free survival was significantly decreased in patients with AS patients of both sexes (P<0.0001). Therefore, AS was found to be associated with an increased risk of cancer. All AS patients must be screened for hematological malignancies, for prostate and bone cancer in males, and for colon cancer in females, particularly younger patients with a CCI ≥2.