Erişkin Vaskülit Hastalarında Kanser Sıklığı ve Gelişimi
Kardaş, Rıza Can
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Vasculitis, like other diseases with chronic inflammation, may be associted with inc-reased cancer risk; possibily due to the inflammation triggering and advancing the neoplastic process. In this study, adult vasculitis patients (except Behçet’s disease) followed at Hacettepe University Cancer Research, Diagnosis and Treatment Center (HUVAM) since 2014 were reviewed for neoplastic development and cancer featu-res. Among 684 patients with a mean age of 46.4±16.9 years (95% CI: 44.9–48.0 years) and a median follow up duration of 29 months (95% CI: 44.7–56.7 months), 38 patients (5.6%) developed cancer. Compared to the general population in Turkey, cancer incidence among vasculitis patients was 10 times higher (SIR: 10, 95% CI: 7.1–13.6, P<0.001). When patients who developed cancer after the diagnosis of can-cer were selected, cancer incidence was found to be about three times higher than the general population (SIR: 3.2, 95% CI: 1.8–5.5, P<0.001). Patients whom both the vasculitis and cancer diagnosis was within the same year, had a higher ratio of male patients (87%, P=0.01), had a higher rate of smoking (77%, P<0.001) and had a worse rate of survival (median survival: 54 months, 95% CI: <1 month–125.9 months, P=0.005). This increase in the cancer incidence may indeed be due to chronic inflammation; however, VDI and BVAS scores during the last visit (median: <0.1) indicate that non-inflammatory factor may play a role as the inflammatory damage caused by vasculitis in these patients seem to be low. In conclusion, com-pared to the general population, cancer incidence is significantly higher in patients with vasculitis and the timing of diagnosis between vasculitis and cancer may be associated with different clinical features.
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