PMID- 28089971 OWN - NLM STAT- MEDLINE DCOM- 20171221 LR - 20180209 IS - 1499-2752 (Electronic) IS - 0315-162X (Linking) VI - 44 IP - 3 DP - 2017 Mar TI - Incidence of Malignancy Prior to Antineutrophil Cytoplasmic Antibody-associated Vasculitis Compared to the General Population. PG - 314-318 LID - 10.3899/jrheum.160885 [doi] AB - OBJECTIVE: Previous studies have reported an increased malignancy risk preceding antineutrophil cytoplasmic antibody-associated vasculitis (AAV), suggesting common pathogenic pathways in these 2 entities. However, the study results were conflicting and often limited to patients with granulomatosis with polyangiitis (GPA). Here, we study the malignancy risk prior to AAV diagnosis [either GPA or microscopic polyangiitis (MPA)] to elaborate on the putative association between malignancy and AAV. METHODS: A total of 203 patients were selected for the current study. Malignancies prior to AAV diagnosis were identified using a nationwide pathology database, and their occurrence was verified by reviewing the medical files of 145 patients (71.4%). The malignancy incidence was compared to the general population by calculation of standardized incidence ratios (SIR), matching for sex, age, and time period. SIR were calculated for 2 intervals: < 2 years and >/= 2 years prior to AAV diagnosis. Separate analyses were performed for GPA and MPA. RESULTS: The overall risk for malignancy prior to AAV diagnosis was similar to that of the general population (SIR 0.96, 95% CI 0.55-1.57), as was true when risks were analyzed by malignancy type, including skin, bladder, kidney, lung, stomach, rectum, and uterus (SIR ranged from 1.64 to 4.14). We found no significant difference in malignancy risk between patients with GPA and MPA. CONCLUSION: Our findings do not support the hypothesis that preceding malignancies and AAV have a causal relationship or shared pathogenic pathways. FAU - van Daalen, Emma E AU - van Daalen EE AD - From the Department of Pathology, and the Department of Medical Statistics and Bioinformatics, Leiden University Medical Center, Leiden, the Netherlands. e.e.van_daalen@lumc.nl. AD - E.E. van Daalen, BSc, Department of Pathology, Leiden University Medical Center; C. Rahmattulla, BSc, Department of Pathology, Leiden University Medical Center; R. Wolterbeek, MD, Department of Medical Statistics and Bioinformatics, Leiden University Medical Center; J.A. Bruijn, MD, PhD, Department of Pathology, Leiden University Medical Center; and I.M. Bajema, MD, PhD, Department of Pathology, Leiden University Medical Center. e.e.van_daalen@lumc.nl. FAU - Rahmattulla, Chinar AU - Rahmattulla C AD - From the Department of Pathology, and the Department of Medical Statistics and Bioinformatics, Leiden University Medical Center, Leiden, the Netherlands. AD - E.E. van Daalen, BSc, Department of Pathology, Leiden University Medical Center; C. Rahmattulla, BSc, Department of Pathology, Leiden University Medical Center; R. Wolterbeek, MD, Department of Medical Statistics and Bioinformatics, Leiden University Medical Center; J.A. Bruijn, MD, PhD, Department of Pathology, Leiden University Medical Center; and I.M. Bajema, MD, PhD, Department of Pathology, Leiden University Medical Center. FAU - Wolterbeek, Ron AU - Wolterbeek R AD - From the Department of Pathology, and the Department of Medical Statistics and Bioinformatics, Leiden University Medical Center, Leiden, the Netherlands. AD - E.E. van Daalen, BSc, Department of Pathology, Leiden University Medical Center; C. Rahmattulla, BSc, Department of Pathology, Leiden University Medical Center; R. Wolterbeek, MD, Department of Medical Statistics and Bioinformatics, Leiden University Medical Center; J.A. Bruijn, MD, PhD, Department of Pathology, Leiden University Medical Center; and I.M. Bajema, MD, PhD, Department of Pathology, Leiden University Medical Center. FAU - Bruijn, Jan A AU - Bruijn JA AD - From the Department of Pathology, and the Department of Medical Statistics and Bioinformatics, Leiden University Medical Center, Leiden, the Netherlands. AD - E.E. van Daalen, BSc, Department of Pathology, Leiden University Medical Center; C. Rahmattulla, BSc, Department of Pathology, Leiden University Medical Center; R. Wolterbeek, MD, Department of Medical Statistics and Bioinformatics, Leiden University Medical Center; J.A. Bruijn, MD, PhD, Department of Pathology, Leiden University Medical Center; and I.M. Bajema, MD, PhD, Department of Pathology, Leiden University Medical Center. FAU - Bajema, Ingeborg M AU - Bajema IM AD - From the Department of Pathology, and the Department of Medical Statistics and Bioinformatics, Leiden University Medical Center, Leiden, the Netherlands. AD - E.E. van Daalen, BSc, Department of Pathology, Leiden University Medical Center; C. Rahmattulla, BSc, Department of Pathology, Leiden University Medical Center; R. Wolterbeek, MD, Department of Medical Statistics and Bioinformatics, Leiden University Medical Center; J.A. Bruijn, MD, PhD, Department of Pathology, Leiden University Medical Center; and I.M. Bajema, MD, PhD, Department of Pathology, Leiden University Medical Center. LA - eng PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20170115 PL - Canada TA - J Rheumatol JT - The Journal of rheumatology JID - 7501984 SB - IM MH - Adult MH - Aged MH - Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis/*epidemiology MH - Female MH - Humans MH - Incidence MH - Male MH - Middle Aged MH - Neoplasms/*epidemiology OTO - NOTNLM OT - ANTINEUTROPHIL CYTOPLASMIC ANTIBODIES OT - MALIGNANCY OT - VASCULITIS EDAT- 2017/01/17 06:00 MHDA- 2017/12/22 06:00 CRDT- 2017/01/17 06:00 PHST- 2016/11/10 00:00 [accepted] PHST- 2017/01/17 06:00 [pubmed] PHST- 2017/12/22 06:00 [medline] PHST- 2017/01/17 06:00 [entrez] AID - jrheum.160885 [pii] AID - 10.3899/jrheum.160885 [doi] PST - ppublish SO - J Rheumatol. 2017 Mar;44(3):314-318. doi: 10.3899/jrheum.160885. Epub 2017 Jan 15.