Cancer in ANCA-Associated Glomerulonephritis: A Registry-Based Cohort Study
Background. Immunosuppressive therapy for antineutrophil cytoplasmic antibody-associated vasculitis has been associated with increased malignancy risk. Objectives. To quantify the cancer risk associated with contemporary cyclophosphamide-sparing protocols. Methods. Patients from the Norwegian Kidney...
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| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2017-01-01
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| Series: | International Journal of Nephrology |
| Online Access: | http://dx.doi.org/10.1155/2017/6013038 |
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| author | Sanjeevan Sriskandarajah Leif Bostad Tor Åge Myklebust Bjørn Møller Steinar Skrede Rune Bjørneklett |
| author_facet | Sanjeevan Sriskandarajah Leif Bostad Tor Åge Myklebust Bjørn Møller Steinar Skrede Rune Bjørneklett |
| author_sort | Sanjeevan Sriskandarajah |
| collection | DOAJ |
| description | Background. Immunosuppressive therapy for antineutrophil cytoplasmic antibody-associated vasculitis has been associated with increased malignancy risk. Objectives. To quantify the cancer risk associated with contemporary cyclophosphamide-sparing protocols. Methods. Patients from the Norwegian Kidney Biopsy Registry between 1988 and 2012 who had biopsy-verified pauci-immune glomerulonephritis and positive antineutrophil cytoplasmic antibody (ANCA) serology were included. Standardised incidence ratios (SIRs) were calculated to compare the study cohort with the general population. Results. The study cohort included 419 patients. During 3010 person-years, cancer developed in 41 patients (9.79%); the expected number of cancer cases was 37.5 (8.95%). The cohort had SIRs as follows: 1.09, all cancer types (95% CI, 0.81 to 1.49); 0.96, all types except nonmelanoma skin cancer (95% CI, 0.69 to 1.34); 3.40, nonmelanoma skin cancer (95% CI, 1.62 to 7.14); 3.52, hematologic cancer (95% CI, 1.32 to 9.37); 2.12, posttransplant cancer (95% CI, 1.01 to 4.44); and 1.53, during the 1–5-year follow-up after diagnosis (95% CI, 1.01 to 2.32). Conclusions. Cancer risk did not increase significantly in this cohort with ANCA-associated glomerulonephritis. However, increased risk of nonmelanoma skin cancer, posttransplant cancer, and hematologic cancer indicates an association between immunosuppression and malignancy. |
| format | Article |
| id | doaj-art-1bd7021d924e4bf1bccb9a1816614b73 |
| institution | Kabale University |
| issn | 2090-214X 2090-2158 |
| language | English |
| publishDate | 2017-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | International Journal of Nephrology |
| spelling | doaj-art-1bd7021d924e4bf1bccb9a1816614b732025-02-03T05:44:16ZengWileyInternational Journal of Nephrology2090-214X2090-21582017-01-01201710.1155/2017/60130386013038Cancer in ANCA-Associated Glomerulonephritis: A Registry-Based Cohort StudySanjeevan Sriskandarajah0Leif Bostad1Tor Åge Myklebust2Bjørn Møller3Steinar Skrede4Rune Bjørneklett5Department of Clinical Medicine, University of Bergen, Bergen, NorwayDepartment of Clinical Medicine, University of Bergen, Bergen, NorwayDepartment of Clinical and Registry-Based Research, Cancer Registry of Norway, Institute of Population-Based Cancer Research, Oslo, NorwayDepartment of Clinical and Registry-Based Research, Cancer Registry of Norway, Institute of Population-Based Cancer Research, Oslo, NorwayDepartment of Clinical Science, University of Bergen, Bergen, NorwayDepartment of Clinical Medicine, University of Bergen, Bergen, NorwayBackground. Immunosuppressive therapy for antineutrophil cytoplasmic antibody-associated vasculitis has been associated with increased malignancy risk. Objectives. To quantify the cancer risk associated with contemporary cyclophosphamide-sparing protocols. Methods. Patients from the Norwegian Kidney Biopsy Registry between 1988 and 2012 who had biopsy-verified pauci-immune glomerulonephritis and positive antineutrophil cytoplasmic antibody (ANCA) serology were included. Standardised incidence ratios (SIRs) were calculated to compare the study cohort with the general population. Results. The study cohort included 419 patients. During 3010 person-years, cancer developed in 41 patients (9.79%); the expected number of cancer cases was 37.5 (8.95%). The cohort had SIRs as follows: 1.09, all cancer types (95% CI, 0.81 to 1.49); 0.96, all types except nonmelanoma skin cancer (95% CI, 0.69 to 1.34); 3.40, nonmelanoma skin cancer (95% CI, 1.62 to 7.14); 3.52, hematologic cancer (95% CI, 1.32 to 9.37); 2.12, posttransplant cancer (95% CI, 1.01 to 4.44); and 1.53, during the 1–5-year follow-up after diagnosis (95% CI, 1.01 to 2.32). Conclusions. Cancer risk did not increase significantly in this cohort with ANCA-associated glomerulonephritis. However, increased risk of nonmelanoma skin cancer, posttransplant cancer, and hematologic cancer indicates an association between immunosuppression and malignancy.http://dx.doi.org/10.1155/2017/6013038 |
| spellingShingle | Sanjeevan Sriskandarajah Leif Bostad Tor Åge Myklebust Bjørn Møller Steinar Skrede Rune Bjørneklett Cancer in ANCA-Associated Glomerulonephritis: A Registry-Based Cohort Study International Journal of Nephrology |
| title | Cancer in ANCA-Associated Glomerulonephritis: A Registry-Based Cohort Study |
| title_full | Cancer in ANCA-Associated Glomerulonephritis: A Registry-Based Cohort Study |
| title_fullStr | Cancer in ANCA-Associated Glomerulonephritis: A Registry-Based Cohort Study |
| title_full_unstemmed | Cancer in ANCA-Associated Glomerulonephritis: A Registry-Based Cohort Study |
| title_short | Cancer in ANCA-Associated Glomerulonephritis: A Registry-Based Cohort Study |
| title_sort | cancer in anca associated glomerulonephritis a registry based cohort study |
| url | http://dx.doi.org/10.1155/2017/6013038 |
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