LAUSR

Recent studies have identified neoplasms as the second most common cause of death in patients with Takayasu’s arteritis (TAK) [1,2]. Various autoimmune diseases are related to the increased rates of malignancies. Despite conflicting data, most studies concluded that there is no increase in the risk of malignancies in giant cell arteritis [3]. In the case of TAK, there have been few reports of malignancies [4]. However, only one study compared the risk of malignancies in TAK to that of the general population [5]. Because the previous study only included 180 patients with TAK from single center, no definite conclusion could be drawn. Here, we evaluated the relative risk of malignancies in patients with TAK and compared them with the general population using the medical insurance data of South Korea.This study aimed to evaluate the relative risk of malignancy in patients with TAK compared to that in the general population.This retrospective nationwide cohort study used data from the Korean Health Insurance Review and Assessment Service database. All newly diagnosed patients with Takayasu’s arteritis were identified between January 2009 and December 2019. They were observed until the diagnosis of malignancy, death, or end of the observational period, December 2020. The occurrence of malignancy was regarded as the first claim under ICD-10 codes, including C00–97, D46, and D47.1, according to the incidence of malignancy classification published by the National Cancer Registry (NCR). The incidence of malignancy in the general population was retrieved from the 2014 NCR, which collects the annual incidence of malignancies in the entire population of South Korea. The standardized incidence ratios (SIRs) of the overall and site-specific malignancies were estimated and compared with the incidence of cancer in the general population.We identified 1,449 newly diagnosed patients with Takayasu’s arteritis during the observational period (9,196 person-years). A total of 74, 66, and 8 patients had overall, solid, and hematologic malignancies, respectively. The risks of overall (SIR, 1.62; 95% confidence interval [CI], 1.27–2.03), solid (SIR, 2.04; 95% CI, 1.56–2.61), and hematologic (SIR, 4.05; 95% CI, 3.72–7.98) malignancies were increased compared to those in the general population. In solid malignancies, breast (SIR, 2.07; 95% CI, 1.16–3.42), ovarian (SIR, 4.45; 95% CI, 1.21–11.39), and major salivary gland (SIR, 19.04; 95% CI, 2.31–68.76) cancers had an increased risk. In hematologic malignancies, the risk of myelodysplasia increased (SIR, 18.02; 95% CI, 3.72–52.66). Immunosuppressive agent use was not associated with malignancy. There was no specific period when cancer more frequently occurred.An increased risk of malignancy was observed in patients with Takayasu’s arteritis compared to that in the general population in this large-scale nationwide population study of Korean health insurance data.[1]Garen T, Lerang K, Hoffmann-Vold A-M, Andersson H, Midtvedt Ø, Brunborg C, et al. Mortality and causes of death across the systemic connective tissue diseases and the primary systemic vasculitides. Rheumatology. 2018;58(2):313-20.[2]Jang SY, Park TK, Kim D-K. Survival and causes of death for Takayasu’s arteritis in Korea: A retrospective population-based study. International Journal of Rheumatic Diseases. 2021;24(1):69-73.[3]Hill CL, Cole A, Rischmueller M, Dodd T, Coleman M, Tucker G, et al. Risk of cancer in patients with biopsy-proven giant cell arteritis. Rheumatology (Oxford). 2010;49(4):756-9.[4]Bicakcigil M, Aksu K, Kamali S, Ozbalkan Z, Ates A, Karadag O, et al. Takayasu’s arteritis in Turkey - clinical and angiographic features of 248 patients. Clin Exp Rheumatol. 2009;27(1 Suppl 52):S59-64.[5]Park JK, Choi IA, Lee EY, Song YW, Lee EB. Incidence of malignancy in Takayasu arteritis in Korea. Rheumatol Int. 2014;34(4):517-21.None declared