Cumulative Incidence of Cancer Screening for Breast, Cervical, Prostate, and Colorectal Cancer in Patients with Rheumatoid Arthritis.

OBJECTIVE

To determine the incidence of breast, cervical, prostate, and colorectal cancer screening in patients with RA versus matched non-RA comparators.

METHODS

We performed a retrospective, matched cohort study of patients with and without RA living in an 8-county region of southern Minnesota on January 1, 2015. Through review of medical records, patients who fulfilled either the 1987 ACR or 2010 ACR/EULAR classification criteria for RA were identified. Patients with RA were matched 1:1 to non-RA comparators on age, sex, and county of residence. Cancer screening was determined from review of the U.S. Preventative Task Force recommendations. Cumulative incidence of cancer screening was estimated accounting for the competing risk of death, and Cox proportional hazard models adjusted for age, smoking and race assessed for the risk of delay.

RESULTS

The study included 1,614 patients with RA and 1,597 comparators without RA (mean age 63 years; 71% female). At 5-years of follow-up, 51.6% [95%CI:47.9-55.6%] of the RA cohort had cervical cancer screening compared to 58.2% [95%CI:54.5-62.2%] in the non-RA cohort. After adjusting for age, smoking, and race, RA was associated with decreased cervical cancer screening (aHR:0.83 [95%CI:0.72-0.96]). RA was not significantly associated with a decrease in breast (aHR:0.98 [95%CI:0.87-1.10]), prostate (aHR:0.99 [95%CI:0.74-1.34]), or colorectal (aHR:1.04 [95%CI:0.93-1.16]) cancer screening.

CONCLUSION

Women with RA were more likely to experience delayed cervical cancer screening. Increased diligence by healthcare providers to ensure cervical cancer screening in RA patients is important to reduce the morbidity and mortality seen in patients with RA.