Lung complications + rheumatoid arthritis increase risk for lung cancer

The risk for lung cancer is high in patients with rheumatoid arthritis (RA) and pulmonary complications, according to a study published online Sept. 3 in Modern Rheumatology.

Shunsuke Mori, M.D., Ph.D., from the Kumamoto Saishun Medical Center in Koshi, Japan, and colleagues assessed the incidence and predictive factors of lung cancer in people with RA. The analysis included 771 patients who were diagnosed with RA at a single institution between April 2001 and December 2022.

The researchers found that 3.5 percent of patients were diagnosed with combined pulmonary fibrosis and emphysema (CPFE), 4.9 percent with interstitial lung disease (ILD) alone, and 6.0 percent with emphysema alone. During a mean of 9.3 years, the crude incidence rates of lung cancer were 2.9, 47.8, 10.5, 11.9, and 0.8 per 1,000 patient-years in all patients, CPFE patients, ILD patients, emphysema patients, and patients without these complications, respectively. Compared with the general population, the standardized incidence ratios (95 percent confidence intervals) were 2.53 (1.29 to 3.77) for male patients and 0.89 (0.57 to 1.16) for female patients. The risk for lung cancer was found to be higher across conditions versus that seen in patients without complications (adjusted hazard ratios [95 percent confidence intervals], 13.48 [3.14 to 57.85] for CPFE, 6.42 [1.42 to 29.09] for ILD alone, and 4.65 [1.18 to 18.30] for emphysema alone).

“Close monitoring of lung cancer is needed for RA patients with smoking history and pulmonary complications, especially CPFE,” the authors write.

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