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Multicenter Study
. 2024 Jun;19(4):1025-1034.
doi: 10.1007/s11739-024-03577-9. Epub 2024 Mar 29.

Unveiling cancer risk in ANCA-associated vasculitis: result from the Turkish Vasculitis Study Group (TRVaS)

Emre Bilgin  1   2 , Tuba Demirci Yıldırım  3 , Bahar Özdemir Ulusoy  4 , Tahir Saygın Öğüt  5 , Murat Karabacak  6 , Öznur Sadioğlu Çağdaş  7 , Reşit Yıldırım  8 , Deniz Can Güven  9 , Cansu Akleylek  10 , Elif Ediboğlu  11 , Muhammet Emin Kutu  12 , Duygu Özgür  13 , Rıza Can Kardaş  14 , Ertuğrul Çağrı Bölek  1   2 , Güllü Sandal Uzun  1   2 , Zehra Özsoy  1   2 , Emine Sarıyıldız  1   2 , Gizem Ayan  1   2 , Berkan Armağan  4 , Abdulsamet Erden  14 , Levent Kılıç  1   2 , Funda Erbasan  5 , Fatma Alibaz-Öner  6 , Ebru Aşıcıoğlu  6 , Ayten Yazıcı  7 , Nazife Şule Bilge  8 , Hamit Küçük  14 , Selda Çelik  12 , Cemal Bes  13 , Servet Akar  11 , Neslihan Yılmaz  10 , Timucin Kaşifoglu  8 , Ayse Cefle  7 , Haner Direskeneli  6 , Veli Yazısız  5 , Ömer Dizdar  15 , Ahmet Omma  4 , Fatoş Önen  3 , Ömer Karadağ  16   17
Affiliations
Multicenter Study

Unveiling cancer risk in ANCA-associated vasculitis: result from the Turkish Vasculitis Study Group (TRVaS)

Emre Bilgin et al. Intern Emerg Med. 2024 Jun.

Erratum in

  • Correction: Unveiling cancer risk in ANCA-associated vasculitis: result from the Turkish Vasculitis Study Group (TRVaS).
    Bilgin E, Yıldırım TD, Ulusoy BÖ, Öğüt TS, Karabacak M, Çağdaş ÖS, Yıldırım R, Güven DC, Akleylek C, Ediboğlu E, Kutu ME, Özgür D, Kardaş RC, Bölek EÇ, Uzun GS, Özsoy Z, Sarıyıldız E, Ayan G, Armağan B, Erden A, Kılıç L, Erbasan F, Alibaz-Öner F, Aşıcıoğlu E, Yazıcı A, Bilge NŞ, Küçük H, Çelik S, Bes C, Akar S, Yılmaz N, Kaşifoglu T, Cefle A, Direskeneli H, Yazısız V, Dizdar Ö, Omma A, Önen F, Karadağ Ö. Bilgin E, et al. Intern Emerg Med. 2024 Aug;19(5):1517. doi: 10.1007/s11739-024-03637-0. Intern Emerg Med. 2024. PMID: 38814522 Free PMC article. No abstract available.

Abstract

To investigate cancer incidence in patients with ANCA-associated vasculitis (AAV), compare it with the age/sex-specific cancer risk of the Turkish population, and explore independent risk factors associated with cancer. This multicenter, incidence case-control study was conducted using the TRVaS registry. AAV patients without cancer history before AAV diagnosis were included. Demographic and AAV-related data of patients with and without an incident cancer were compared. Standardized cancer incidence rates were calculated using age-/sex-specific 2017 Turkish National Cancer Registry data for cancers (excluding non-melanoma skin cancers). Cox regression was performed to find factors related to incident cancers in AAV patients. Of 461 AAV patients (236 [51.2%] male), 19 had incident cancers after 2022.8 patient-years follow-up. Median (IQR) disease duration was 3.4 (5.5) years, and 58 (12.6%) patients died [7 with cancer and one without cancer (log-rank, p = 0.04)]. Cancer-diagnosed patients were older, mostly male, and more likely to have anti-PR3-ANCA positivity. The cumulative cyclophosphamide dose was similar in patients with and without cancer. Overall cancer risk in AAV was 2.1 (SIR) ((1.3-3.2), p = 0.004); lung and head-neck [primary target sites for AAV] cancers were the most common. In Cox regression, male sex and ≥ 60 years of age at AAV diagnosis were associated with increased cancer risk, while receiving rituximab was associated with decreased cancer risk. Cancer risk was 2.1 times higher in AAV patients than the age-/sex-specific cancer risk of the Turkish population population, despite a high rate of rituximab use and lower dose of cyclophosphamide doses. Vigilance in cancer screening for AAV patients covering lung, genitourinary, and head-neck regions, particularly in males and the elderly, is vital.

Keywords: ANCA-associated vasculitis; Cancer; Cyclophosphamide; Granulomatous polyangiitis; Head–neck cancers; Lung cancer; Rituximab.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Fig. 1
Fig. 1
Distribution of cancer sites in AAV patients
See this image and copyright information in PMC

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