Tags

Type your tag names separated by a space and hit enter

Increased cancer risks among arthroplasty patients: 30 year follow-up of the Swedish Knee Arthroplasty Register.
Eur J Cancer. 2011 May; 47(7):1061-71.EJ

Abstract

BACKGROUND

An increasing number of young patients are undergoing knee arthroplasties. Thus, the long-term risks of having a knee prosthesis must be evaluated. This study focuses on the potential carcinogenic effects of the prosthesis; it is a long-term follow-up of all patients in Sweden between 1975 and 2006.

METHODS

The incidence of cancer in a total population of operated individuals was compared to the overall national cancer incidence in Sweden by means of standardised incidence ratios. Analysis of cancer latency period was performed to identify potential aetiological factors.

RESULTS

For male and female patients with rheumatoid arthritis (RA) or osteoarthritis (OA), the overall cancer risks were elevated, ranging from 1.10 (95% confidence interval (CI): 1.03-1.18) for men with OA to 1.26 (1.23-1.29) for men with RA. The greatest increases in risk were observed for the leukaemia subtypes, myelodysplastic syndromes (MDS) and essential thrombocytosis (ET), ranging from 3.31 (1.24-8.83) for ET in men with OA to 7.38 (1.85-29.51) for ET in women with RA. Increases in risk were also observed for breast cancer, prostate cancer and melanoma. The latency analysis revealed elevated risks late in the study period for both solid and haematopoietic cancers. However, only increases in MDS and possibly prostate cancer and melanoma rates appeared to be connected to the operation.

CONCLUSION

This study showed that OA and RA arthroplasty patients have a significantly higher risk of cancer than the general population. Elevated risks of MDS and possibly prostate cancer and melanoma indicated a potential connection to exposure to metals in the implant. The observed excessive incidence of ET was likely associated with the inflammatory disease.

Authors+Show Affiliations

Institute of Clinical Sciences Lund, Department of Orthopedics, Lund University Hospital, Lund University, Sweden. pw@nko.seNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

21227681

Citation

Wagner, Philippe, et al. "Increased Cancer Risks Among Arthroplasty Patients: 30 Year Follow-up of the Swedish Knee Arthroplasty Register." European Journal of Cancer (Oxford, England : 1990), vol. 47, no. 7, 2011, pp. 1061-71.
Wagner P, Olsson H, Lidgren L, et al. Increased cancer risks among arthroplasty patients: 30 year follow-up of the Swedish Knee Arthroplasty Register. Eur J Cancer. 2011;47(7):1061-71.
Wagner, P., Olsson, H., Lidgren, L., Robertsson, O., & Ranstam, J. (2011). Increased cancer risks among arthroplasty patients: 30 year follow-up of the Swedish Knee Arthroplasty Register. European Journal of Cancer (Oxford, England : 1990), 47(7), 1061-71. https://doi.org/10.1016/j.ejca.2010.11.023
Wagner P, et al. Increased Cancer Risks Among Arthroplasty Patients: 30 Year Follow-up of the Swedish Knee Arthroplasty Register. Eur J Cancer. 2011;47(7):1061-71. PubMed PMID: 21227681.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Increased cancer risks among arthroplasty patients: 30 year follow-up of the Swedish Knee Arthroplasty Register. AU - Wagner,Philippe, AU - Olsson,Håkan, AU - Lidgren,Lars, AU - Robertsson,Otto, AU - Ranstam,Jonas, Y1 - 2011/01/10/ PY - 2010/09/06/received PY - 2010/11/23/revised PY - 2010/11/24/accepted PY - 2011/1/14/entrez PY - 2011/1/14/pubmed PY - 2011/11/16/medline SP - 1061 EP - 71 JF - European journal of cancer (Oxford, England : 1990) JO - Eur J Cancer VL - 47 IS - 7 N2 - BACKGROUND: An increasing number of young patients are undergoing knee arthroplasties. Thus, the long-term risks of having a knee prosthesis must be evaluated. This study focuses on the potential carcinogenic effects of the prosthesis; it is a long-term follow-up of all patients in Sweden between 1975 and 2006. METHODS: The incidence of cancer in a total population of operated individuals was compared to the overall national cancer incidence in Sweden by means of standardised incidence ratios. Analysis of cancer latency period was performed to identify potential aetiological factors. RESULTS: For male and female patients with rheumatoid arthritis (RA) or osteoarthritis (OA), the overall cancer risks were elevated, ranging from 1.10 (95% confidence interval (CI): 1.03-1.18) for men with OA to 1.26 (1.23-1.29) for men with RA. The greatest increases in risk were observed for the leukaemia subtypes, myelodysplastic syndromes (MDS) and essential thrombocytosis (ET), ranging from 3.31 (1.24-8.83) for ET in men with OA to 7.38 (1.85-29.51) for ET in women with RA. Increases in risk were also observed for breast cancer, prostate cancer and melanoma. The latency analysis revealed elevated risks late in the study period for both solid and haematopoietic cancers. However, only increases in MDS and possibly prostate cancer and melanoma rates appeared to be connected to the operation. CONCLUSION: This study showed that OA and RA arthroplasty patients have a significantly higher risk of cancer than the general population. Elevated risks of MDS and possibly prostate cancer and melanoma indicated a potential connection to exposure to metals in the implant. The observed excessive incidence of ET was likely associated with the inflammatory disease. SN - 1879-0852 UR - https://www.unboundmedicine.com/medline/citation/21227681/Increased_cancer_risks_among_arthroplasty_patients:_30_year_follow_up_of_the_Swedish_Knee_Arthroplasty_Register_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0959-8049(10)01127-5 DB - PRIME DP - Unbound Medicine ER -