Rheumatoid arthritis patients take-up cancer screening

By Lynda Williams

Insurance records for rheumatoid arthritis (RA) patients in the USA indicate that patients are receiving their recommended cervical, breast, and colon cancer screening tests.

The study, published in Arthritis and Rheumatism, suggests that, contrary to fears of underutilization of health resources by this population, RA patients with health insurance are significantly more likely to attend screening than other insured individuals.

Data from a large commercial insurance plan for 13,314 RA patients and 212,324 patients with other diagnoses gave an overall average screening rate of once every 3 years for cervical cancer, and every 2 years for breast cancer.

After adjusting for age, female RA patients were a significant 1.21 times more likely to undergo one or more Papanicolaou smear tests, 1.49 times more likely to undergo mammography, and 1.69 times more likely to undergo colonoscopy than controls.

Men with RA were a significant 1.52 times more likely to undergo colonoscopy than controls, add Seoyoung Kim and co-authors from Brigham and Women's Hospital, Boston, Massachusetts, USA.

These results were not significantly altered after adjusting for physician visits, percentage of visits made to primary care physicians, and comorbidity.

However, the researchers note that it is not yet clear what the appropriate rate of screening for breast, cervical, and colon cancer in patients with RA should be.

Noting that patients with RA have a confirmed increased risk for cancer, contributing to their risk for early death, the team suggest: "Given the increased risk of some cancers in RA and concerns in the association between various types of RA treatment and malignancy, it may be worth investigating the effectiveness of current cancer screening guidelines in patients with RA and in subgroups on specific treatments."

In the meantime, they conclude: "Continuous efforts should be made to improve and maintain both patients' and physicians' awareness of importance of preventive health services in patients with chronic disease such as RA."

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