Incidence of Cancer among Men with the Felty Syndrome

Incidence of Cancer among Men with the Felty Syndrome

From the National Cancer Institute and the National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, Bethesda, Maryland. Requests for Reprints: Gloria Gridley, National Cancer Institute, EPN 443, Bethesda, MD 20892. Acknowledgments: The authors thank the Medical Administration Service of the Veterans Health Services and Research Administration, whose employees provided the data on which this study is based; Ms. Julie Buckland and Ms. Gigi Yuan of Information Management Services Inc. for computer support; Ms. Deborah Levy, Ms. Emilie Gillanders, Ms. Winifred Evans, Ms. Pat Clark, Mr. Glen Harke, Ms. Betsy Reed, and Ms. Jeanne Rosenthal of WESTAT for medical record research and study management; and Dr. Zdenek Hrubec, Dr. Martha Linet, and Ms. Roselyn Weil of the National Cancer Institute and Dr. William Page of the National Academy of Sciences for advice and guidance.

Abstract

Objective: To estimate the incidence of cancer (especially lymphoproliferative malignancies) in patients with the Felty syndrome.

Design: A retrospective cohort study.

Setting: A computerized database of all discharge records for 1969 to 1990 from a Veterans Affairs hospital.

Patients: 906 men with a discharge diagnosis of the Felty syndrome.

Measurements: Standardized incidence ratios (SIR) (ratios of observed-to-expected events) estimated the risk for specific cancers. Hospital records confirmed the diagnoses of the Felty syndrome and cancer.

Results: We observed a twofold increase in total cancer incidence (137 patients; SIR = 2.09; 95% CI, 1.8 to 2.5). The risk for non-Hodgkin lymphoma (19 patients; SIR = 12.8, CI, 7.7 to 20.0) was much greater than the twofold increase in risk for lymphoma generally reported for rheumatoid arthritis. The risk for leukemia was increased but only within 5 years of the first hospitalization for the Felty syndrome, (13 patients; SIR = 7.67; CI, 4.1 to 13.1).

Conclusion: The increased risk for non-Hodgkin lymphoma after the Felty syndrome in our study is similar to the risk associated with the Sjogren syndrome and may reflect similar immunostimulatory mechanisms.