{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T07:38:15Z","timestamp":1780472295584,"version":"3.54.1"},"reference-count":16,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2010,11,30]],"date-time":"2010-11-30T00:00:00Z","timestamp":1291075200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100004342","name":"Wyeth","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100004342","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arthritis &amp; Rheumatism"],"published-print":{"date-parts":[[2010,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Reports of therapy\u2010related adverse events suggest an elevated rate of malignancy in patients with juvenile idiopathic arthritis (JIA) treated with biologic therapies. However, the scarcity of data on the underlying risk of malignancy in JIA hampers interpretation of these signals. Therefore, the aim of this study was to determine the risk of cancer in patients with JIA as compared with that in the general population.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Through linkage with a national database, the Swedish Patient Register (comprising inpatient discharges in 1969\u20132007 and specialist outpatient visits in 2001\u20132007 in Sweden), a national JIA cohort (n = 9,027) was identified, and each JIA case was matched with 5 general population comparators. Using data from the Swedish Cancer, Census, Death, and Biologics Registers, the occurrence of cancer, vital status, and start of a biologic therapy were identified. The relative risk (RR) of first occurrence of a primary cancer in patients who had not been treated with biologics (biologics\u2010naive patients with JIA) was estimated using Poisson regression, stratified a priori by year of earliest identification of JIA (before 1987 versus 1987 and thereafter). In sensitivity analyses, the data were followed up to 1999, when biologics first became available.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In this biologics\u2010naive JIA cohort, 60 malignancies were observed during 131,144 person\u2010years of followup, compared with 266 cancers observed during 661,758 person\u2010years in the general population comparator (0.46 cases\/1,000 person\u2010years versus 0.40 cases\/1,000 person\u2010years; RR 1.1, 95% confidence interval [95% CI] 0.9\u20131.5). Patients with JIA identified before 1987 were not at increased risk of cancer, whereas JIA identified in 1987 and thereafter was significantly associated with incident lymphoproliferative malignancies (RR 4.2, 95% CI 1.7\u201310.7) and cancers overall (RR 2.3, 95% CI 1.2\u20134.4). Sensitivity analyses did not reveal any ready explanation for this heterogeneity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Although absolute risks were low, an elevated risk of malignancy was observed among biologics\u2010naive patients in whom the diagnosis of JIA was made in the past 20 years, which may have implications for the interpretation of cancer signals in patients with JIA treated with newer therapies.<\/jats:p><\/jats:sec>","DOI":"10.1002\/art.27741","type":"journal-article","created":{"date-parts":[[2010,9,8]],"date-time":"2010-09-08T16:47:18Z","timestamp":1283964438000},"page":"3776-3782","source":"Crossref","is-referenced-by-count":96,"title":["Juvenile idiopathic arthritis and risk of cancer: A nationwide cohort study"],"prefix":"10.1002","volume":"62","author":[{"given":"J. F.","family":"Simard","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Neovius","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Hagelberg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Askling","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2010,11,30]]},"reference":[{"key":"e_1_2_8_2_2","unstructured":"US Food and Drug Administration MedWatch. Information for healthcare professionals: tumor necrosis factor (TNF) blockers. URL:http:\/\/www.fda.gov\/Drugs\/DrugSafety\/PostmarketDrugSafetyInformationforPatientsandProviders\/DrugSafetyInformationforHeathcareProfessionals\/ucm174474.htm."},{"key":"e_1_2_8_3_2","unstructured":"US Food and Drug Administration MedWatch. Questions and answers: TNF blockers. URL:http:\/\/www.fda.gov\/Drugs\/DrugSafety\/PostmarketDrugSafetyInformationforPatientsandProviders\/DrugSafetyInformationforHeathcareProfessionals\/ucm180694.htm."},{"key":"e_1_2_8_4_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11926-007-0067-1"},{"key":"e_1_2_8_5_2","doi-asserted-by":"publisher","DOI":"10.1097\/BOR.0b013e3282f7c706"},{"key":"e_1_2_8_6_2","volume-title":"Socialstyrelsen","year":"2005"},{"key":"e_1_2_8_7_2","first-page":"598","article-title":"Reliability of the hospital registry: the diagnostic data are better than their reputation","volume":"91","author":"Nilsson AC","year":"1994","journal-title":"Lakartidningen"},{"key":"e_1_2_8_8_2","volume-title":"The National Board of Health and Welfare, Centre for Epidemiology","year":"2009"},{"key":"e_1_2_8_9_2","article-title":"Small\u2010area variations in sales of TNF inhibitors in Sweden between 2000 and 2009","author":"Neovius M","year":"2010","journal-title":"Scand J Rheumatol"},{"key":"e_1_2_8_10_2","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2005.045872"},{"key":"e_1_2_8_11_2","first-page":"S91","article-title":"Malignancy in juvenile idiopathic arthritis","volume":"60","author":"Bernatsky S","year":"2009","journal-title":"Arthritis Rheum"},{"issue":"3","key":"e_1_2_8_12_2","first-page":"631","article-title":"Risk of malignancy in biologics\u2010naive juvenile arthritis patients","volume":"69","author":"Harrison M","year":"2010","journal-title":"Ann Rheum Dis"},{"key":"e_1_2_8_13_2","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0215(20001101)88:3<497::AID-IJC27>3.0.CO;2-J"},{"key":"e_1_2_8_14_2","first-page":"1520","article-title":"Worldwide prevalence of juvenile arthritis: why does it vary so much?","volume":"29","author":"Manners PJ","year":"2002","journal-title":"J Rheumatol"},{"key":"e_1_2_8_15_2","doi-asserted-by":"crossref","first-page":"950","DOI":"10.1542\/peds.90.6.950","article-title":"Epidemiology of juvenile chronic arthritis in southwestern Sweden: a 5\u2010year prospective population study","volume":"90","author":"Gare BA","year":"1992","journal-title":"Pediatrics"},{"key":"e_1_2_8_16_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa023141"},{"issue":"3","key":"e_1_2_8_17_2","first-page":"147","article-title":"Cancer risk in juvenile arthritis patients exposed to etanercept: results from three observational cohorts","volume":"69","author":"Harrison M","year":"2010","journal-title":"Ann Rheum Dis"}],"container-title":["Arthritis &amp; Rheumatism"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fart.27741","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/art.27741","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,10]],"date-time":"2023-10-10T13:43:48Z","timestamp":1696945428000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/art.27741"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2010,11,30]]},"references-count":16,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2010,12]]}},"alternative-id":["10.1002\/art.27741"],"URL":"https:\/\/doi.org\/10.1002\/art.27741","archive":["Portico"],"relation":{},"ISSN":["0004-3591","1529-0131"],"issn-type":[{"value":"0004-3591","type":"print"},{"value":"1529-0131","type":"electronic"}],"subject":[],"published":{"date-parts":[[2010,11,30]]}}}