Higher mortality risk from lung and hematological neoplasms in patients with rheumatoid arthritis: An observational study from the Spanish National Registry

Abstract

Objective: Evaluating the impact of solid organ neoplasms (SON) and hematological neoplasms (HN) on mortality among RA patients in a nationwide study.

Methods: A retrospective, observational comparison of SON and HN-related deaths in RA patients and the general Spanish population was conducted (Spanish Hospital Discharge Database). Binary logistic regression analyzed the impact of RA on mortality risk from each neoplasm.

Results: From 2016 to 2019, 139,531 neoplasm-related deaths were recorded, including 813 (0.6%) from RA patients. Patients with RA presented a lower mortality rate from SON (85.1% vs 91.2%, OR 0.99), mainly due to colorectal carcinoma (8% vs 10.6%, OR 0.67) and hepatocarcinoma (1% vs 2.7%, OR 0.44), but higher lung neoplasms risk (20.2% vs 18.6%, OR 1.31). HN-related deaths were also more prevalent in RA patients (14.9% vs 8.8%, OR 1.73), especially B and T/NK non-Hodgkin's lymphoma (6% vs 2.8%, OR 2.12) and myeloid leukemia (4.4% vs 2.3%, OR 1.92).

Conclusion: RA patients might have a higher mortality risk from lung and hematologic neoplasms. Reducing immunosuppressive burden and developing early-detection programs should be primary goals in this population.