Cancer Causes & Control

, Volume 20, Issue 6, pp 1001–1010 | Cite as

Risk of cancer among rheumatoid arthritis patients in California

  • Arti Parikh-Patel
  • Richard H. White
  • Mark Allen
  • Rosemary Cress
Original Paper



The objective of this retrospective cohort study was to evaluate cancer risk among rheumatoid arthritis (RA) patients in California.


The study cohort derived from statewide patient discharge records was followed via linkage with cancer registry data over the period 1991–2002. Age and sex adjusted standardized incidence ratios (SIRs) and 95% confidence intervals were calculated to compare observed to expected numbers of cancers based on age, race, and sex specific incidence rates in the California population.


Among the 84,475 RA patients, who were observed for 405,540 person-years, 5,533 incident cancers were diagnosed during the observation interval. The risk of developing lymphohematopoietic cancer was significantly higher in the cohort for both sexes. Males had significantly higher risks of lung, liver, and esophageal cancer, but a lower risk of prostate cancer. Females were at significantly decreased risk for several cancers including breast, ovary, uterus, cervix, and melanoma, with the risk reduction ranging from 15 to 57% lower than the general population. Hispanics had increased risks of leukemia, vagina/vulva, lung, and liver cancers.


Studies investigating the mechanisms that underlie the reported associations between RA and specific cancer types are needed.


Cancer Rheumatoid arthritis Registries Cohort studies Neoplasms 



This work was funded by grant 1R21CA100759-01A2 from the National Cancer Institute. The collection of cancer incidence data used in this study was supported by the California Department of Health Services as part of the statewide cancer reporting program mandated by California Health and Safety Code Section 103885; the National Cancer Institute’s Surveillance, Epidemiology and End Results Program under contract N01-PC-35136 awarded to the Northern California Cancer Center, contract N01-PC-35139 awarded to the University of Southern California, and contract N02-PC-15105 awarded to the Public Health Institute; and the Centers for Disease Control and Prevention’s National Program of Cancer Registries, under agreement #U55/CCR921930-02 awarded to the Public Health Institute.


The ideas and opinions expressed herein are those of the author(s) and endorsement by the State of California, Department of Health Services, the National Cancer Institute, and the Centers for Disease Control and Prevention or their Contractors and Subcontractors is not intended nor should be inferred.


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Copyright information

© Springer Science+Business Media B.V. 2009

Authors and Affiliations

  • Arti Parikh-Patel
    • 1
  • Richard H. White
    • 2
  • Mark Allen
    • 1
  • Rosemary Cress
    • 1
    • 3
  1. 1.California Cancer RegistryPublic Health InstituteSacramentoUSA
  2. 2.Department of Internal MedicineUniversity of CaliforniaDavisUSA
  3. 3.Department of Public Health SciencesUniversity of CaliforniaDavisUSA

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