The following is a summary of “Risk of Lung Cancer in Rheumatoid Arthritis and Rheumatoid Arthritis–Associated Interstitial Lung Disease,” published in the July 2024 issue of Rheumatology by Brooks et al.

Researchers conducted a retrospective study assessing the risk of lung cancer in patients with rheumatoid arthritis (RA) and RA-interstitial lung disease (ILD).

They evaluated RA and RA-ILD within the Veterans Health Administration (VA) (2000 to 2019). Patients with RA and RA-ILD were identified using validated administrative-based algorithms and matched (up to 1:10) on age, gender, and VA enrollment year to individuals without RA. Cases of lung cancer were identified by the VA oncology database and the National Death Index. Conditional Cox regression models were used to assess lung cancer risk, adjusting for race, ethnicity, smoking status, Agent Orange exposure, and comorbidity burden. Several sensitivity analyses were also conducted.

The result showed 72,795 patients with RA matched to 633,937 individuals without RA (mean age 63 years; 88% male) over 4,481,323 patient-years, 17,099 incident lung cancers were identified. An independent association between RA and increased lung cancer risk was found (aHR 1.58 [1.52, 1.64]), persisting in non-smokers (aHR 1.65 [1.22, 2.24]) and patients with incident RA (aHR 1.54 [1.44, 1.65]). Compared to controls without RA, patients with prevalent RA-ILD (n=757) exhibited a higher lung cancer risk (aHR 3.25 [2.13, 4.95]) than patients with RA without ILD (aHR 1.57 [1.51, 1.64]). Similar findings were observed for both prevalent and incident cases with RA-ILD (RA-ILD vs. non-RA aHR 2.88 [2.45, 3.40]).

Investigators concluded that RA increased lung cancer risk by over 50%, and RA-ILD tripled the risk, highlighting the need for enhanced lung cancer surveillance.

Source: acrjournals.onlinelibrary.wiley.com/doi/abs/10.1002/art.42961