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dc.contributor.authorWagner, Philippe
dc.contributor.authorOlsson, Håkan
dc.contributor.authorLidgren, Lars
dc.contributor.authorRobertsson, Otto
dc.contributor.authorRanstam, Jonas
dc.date.accessioned2012-05-29T10:36:14Z
dc.date.available2012-05-29T10:36:14Z
dc.date.issued2011-05
dc.date.submitted2012-05-29
dc.identifier.citationEur. J. Cancer 2011, 47(7):1061-71en_GB
dc.identifier.issn1879-0852
dc.identifier.pmid21227681
dc.identifier.doi10.1016/j.ejca.2010.11.023
dc.identifier.urihttp://hdl.handle.net/2336/226391
dc.descriptionTo access publisher full text version of this article. Please click on the hyperlink in Additional Links field.en_GB
dc.description.abstractBACKGROUND: An increasing number of young patients are undergoing knee arthroplasties. Thus, the long-term risks of having a knee prosthesis must be evaluated. This study focuses on the potential carcinogenic effects of the prosthesis; it is a long-term follow-up of all patients in Sweden between 1975 and 2006. METHODS: The incidence of cancer in a total population of operated individuals was compared to the overall national cancer incidence in Sweden by means of standardised incidence ratios. Analysis of cancer latency period was performed to identify potential aetiological factors. RESULTS: For male and female patients with rheumatoid arthritis (RA) or osteoarthritis (OA), the overall cancer risks were elevated, ranging from 1.10 (95% confidence interval (CI): 1.03-1.18) for men with OA to 1.26 (1.23-1.29) for men with RA. The greatest increases in risk were observed for the leukaemia subtypes, myelodysplastic syndromes (MDS) and essential thrombocytosis (ET), ranging from 3.31 (1.24-8.83) for ET in men with OA to 7.38 (1.85-29.51) for ET in women with RA. Increases in risk were also observed for breast cancer, prostate cancer and melanoma. The latency analysis revealed elevated risks late in the study period for both solid and haematopoietic cancers. However, only increases in MDS and possibly prostate cancer and melanoma rates appeared to be connected to the operation. CONCLUSION: This study showed that OA and RA arthroplasty patients have a significantly higher risk of cancer than the general population. Elevated risks of MDS and possibly prostate cancer and melanoma indicated a potential connection to exposure to metals in the implant. The observed excessive incidence of ET was likely associated with the inflammatory disease.
dc.description.sponsorshipSwedish Association of Local Authorities and Regions (SALAR) Faculty of Medicine at Lund University Swedish Research Council Medicine 09509 Stiftelsen for bistand at rorelsehindrade i Skaneen_GB
dc.language.isoenen
dc.publisherElsevier Scienceen_GB
dc.relation.urlhttp://dx.doi.org/10.1016/j.ejca.2010.11.023en_GB
dc.rightsArchived with thanks to European journal of cancer (Oxford, England : 1990)en_GB
dc.subject.meshAgeden_GB
dc.subject.meshAged, 80 and overen_GB
dc.subject.meshArthritis, Rheumatoiden_GB
dc.subject.meshArthroplasty, Replacement, Kneeen_GB
dc.subject.meshCohort Studiesen_GB
dc.subject.meshFemaleen_GB
dc.subject.meshFollow-Up Studiesen_GB
dc.subject.meshHumansen_GB
dc.subject.meshInflammationen_GB
dc.subject.meshKnee Prosthesisen_GB
dc.subject.meshLeukemiaen_GB
dc.subject.meshMaleen_GB
dc.subject.meshMiddle Ageden_GB
dc.subject.meshMyelodysplastic Syndromesen_GB
dc.subject.meshOsteoarthritisen_GB
dc.subject.meshProstatic Neoplasmsen_GB
dc.subject.meshRegistriesen_GB
dc.subject.meshRisken_GB
dc.subject.meshSwedenen_GB
dc.subject.meshThrombocythemia, Essentialen_GB
dc.titleIncreased cancer risks among arthroplasty patients: 30 year follow-up of the Swedish Knee Arthroplasty Register.en
dc.typeArticleen
dc.contributor.departmentInstitute of Clinical Sciences Lund, Department of Orthopedics, Lund University Hospital, Lund University, Sweden. pw@nko.seen_GB
dc.identifier.journalEuropean journal of cancer (Oxford, England : 1990)en_GB
html.description.abstractBACKGROUND: An increasing number of young patients are undergoing knee arthroplasties. Thus, the long-term risks of having a knee prosthesis must be evaluated. This study focuses on the potential carcinogenic effects of the prosthesis; it is a long-term follow-up of all patients in Sweden between 1975 and 2006. METHODS: The incidence of cancer in a total population of operated individuals was compared to the overall national cancer incidence in Sweden by means of standardised incidence ratios. Analysis of cancer latency period was performed to identify potential aetiological factors. RESULTS: For male and female patients with rheumatoid arthritis (RA) or osteoarthritis (OA), the overall cancer risks were elevated, ranging from 1.10 (95% confidence interval (CI): 1.03-1.18) for men with OA to 1.26 (1.23-1.29) for men with RA. The greatest increases in risk were observed for the leukaemia subtypes, myelodysplastic syndromes (MDS) and essential thrombocytosis (ET), ranging from 3.31 (1.24-8.83) for ET in men with OA to 7.38 (1.85-29.51) for ET in women with RA. Increases in risk were also observed for breast cancer, prostate cancer and melanoma. The latency analysis revealed elevated risks late in the study period for both solid and haematopoietic cancers. However, only increases in MDS and possibly prostate cancer and melanoma rates appeared to be connected to the operation. CONCLUSION: This study showed that OA and RA arthroplasty patients have a significantly higher risk of cancer than the general population. Elevated risks of MDS and possibly prostate cancer and melanoma indicated a potential connection to exposure to metals in the implant. The observed excessive incidence of ET was likely associated with the inflammatory disease.


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