Multiple sclerosis and cancer incidence: A Danish nationwide cohort study.
Cancer mortality
Cancer risk
Epidemiology
Multiple sclerosis
Journal
Multiple sclerosis and related disorders
ISSN: 2211-0356
Titre abrégé: Mult Scler Relat Disord
Pays: Netherlands
ID NLM: 101580247
Informations de publication
Date de publication:
Feb 2019
Feb 2019
Historique:
received:
06
09
2018
revised:
20
11
2018
accepted:
13
12
2018
pubmed:
24
12
2018
medline:
14
6
2019
entrez:
22
12
2018
Statut:
ppublish
Résumé
Introduction of disease modifying treatment may have increased the cancer incidence in multiple sclerosis patients. Our aim was to estimate the incidence of any cancer, malignant melanoma, nonmelanoma skin cancer, and female breast cancer, and cancer specific mortality in multiple sclerosis patients diagnosed in 1995-2015 i.e. after introduction of disease modifying treatment. Linking various Danish medical registers, we compared observed cancer incidence and cancer-specific mortality in multiple sclerosis patients versus expected based on general population rates. Among 10,752 multiple sclerosis patients, we identified 5.76 incident cancers per 1,000 person-years. The standardized incidence ratio was 0.98 (95% confidence interval [CI], 0.90-1.06) for any cancer, 0.99 (95% CI, 0.84-1.15) for non-melanoma skin cancer, and 0.98 (95% CI, 0.81-1.18) for female breast cancer. For malignant melanoma, the standardized incidence ratio was 1.51 (95% CI, 1.13-1.98) for the entire period (1995-2015) but 1.16 (95% CI, 0.62-1.99) for 2005-2015. The overall mortality rate was 1.31 (95% CI, 1.09-1.53) per 1000 person-years with a standardized mortality ratio of 0.99 (95% CI, 0.83-1.17). In this nationwide study, multiple sclerosis patients did not have increased cancer incidence or increased cancer-specific mortality. We observed an increased risk of malignant melanoma mainly attributed to increased risk in the first part of our study period.
Sections du résumé
BACKGROUND
BACKGROUND
Introduction of disease modifying treatment may have increased the cancer incidence in multiple sclerosis patients. Our aim was to estimate the incidence of any cancer, malignant melanoma, nonmelanoma skin cancer, and female breast cancer, and cancer specific mortality in multiple sclerosis patients diagnosed in 1995-2015 i.e. after introduction of disease modifying treatment.
METHODS
METHODS
Linking various Danish medical registers, we compared observed cancer incidence and cancer-specific mortality in multiple sclerosis patients versus expected based on general population rates.
RESULTS
RESULTS
Among 10,752 multiple sclerosis patients, we identified 5.76 incident cancers per 1,000 person-years. The standardized incidence ratio was 0.98 (95% confidence interval [CI], 0.90-1.06) for any cancer, 0.99 (95% CI, 0.84-1.15) for non-melanoma skin cancer, and 0.98 (95% CI, 0.81-1.18) for female breast cancer. For malignant melanoma, the standardized incidence ratio was 1.51 (95% CI, 1.13-1.98) for the entire period (1995-2015) but 1.16 (95% CI, 0.62-1.99) for 2005-2015. The overall mortality rate was 1.31 (95% CI, 1.09-1.53) per 1000 person-years with a standardized mortality ratio of 0.99 (95% CI, 0.83-1.17).
CONCLUSION
CONCLUSIONS
In this nationwide study, multiple sclerosis patients did not have increased cancer incidence or increased cancer-specific mortality. We observed an increased risk of malignant melanoma mainly attributed to increased risk in the first part of our study period.
Identifiants
pubmed: 30576846
pii: S2211-0348(18)30543-1
doi: 10.1016/j.msard.2018.12.014
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
81-85Informations de copyright
Copyright © 2018. Published by Elsevier B.V.