{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T05:28:28Z","timestamp":1781674108342,"version":"3.54.5"},"reference-count":13,"publisher":"BMJ","issue":"2","funder":[{"DOI":"10.13039\/501100007949","name":"Swedish Rheumatism Association","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100007949","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["RMD Open"],"accepted":{"date-parts":[[2019,10,22]]},"published-print":{"date-parts":[[2019,11]]},"abstract":"<jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>The risk of cancer, including any secular trends in risk, in patients with juvenile idiopathic arthritis (JIA) is incompletely understood.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We performed a register-based cohort study of patients with JIA from 2001 until 2017, identified via the Swedish Patient Register. Patients with JIA were matched to five population reference subjects. Patients and referents were followed up for incident cancers (via linkage to the Swedish Cancer Register) until 18 years of age or 31 December 2016.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Among the 6721 patients with JIA, we observed 10 incident malignancies (5 lymphoproliferative cancers) during 34\u2009951 person-years of follow-up, corresponding to an excess incidence of 0.09 cancers per 1000 person-years (one extra case per 11\u2009000 patients per year), an HR for cancer (all sites) of 1.4 (95% CI 0.7 to 2.9) and an HR for lymphoproliferative malignancies of 3.6 (95% CI 1.1 to 11.2). The rates of cancer in JIA did not increase over the study period. We noted no differences in the excess risk comparing periods before and after the introduction of biologic disease-modifying antirheumatic drugs (bDMARDs).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Discussion<\/jats:title>\n                  <jats:p>Children and adolescents with JIA are at a slightly increased risk of lymphoproliferative (but not of other) malignancies. At the group level, there is no sign that this risk has increased further after the introduction of bDMARDs.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/rmdopen-2019-001055","type":"journal-article","created":{"date-parts":[[2019,11,14]],"date-time":"2019-11-14T05:35:14Z","timestamp":1573709714000},"page":"e001055","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":14,"title":["Juvenile idiopathic arthritis and risk of cancer before and after the introduction of biological therapies"],"prefix":"10.1136","volume":"5","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2878-4463","authenticated-orcid":false,"given":"AnnaCarin","family":"Horne","sequence":"first","affiliation":[{"name":"Department of Women's and Children's Health, Karolinska Institute, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B\u00e9n\u00e9dicte","family":"Delcoigne","sequence":"additional","affiliation":[{"name":"Clinical Epidemiology Division, Department of Medicine Solna, Karolinska Institute, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karin","family":"Palmblad","sequence":"additional","affiliation":[{"name":"Pediatric Rheumatology, Karolinska Hospital, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johan","family":"Askling","sequence":"additional","affiliation":[{"name":"Clinical Epidemiology Division, Department of Medicine Solna, Karolinska Institute, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2019,11,13]]},"reference":[{"key":"2025090313523959000_5.2.e001055.1","doi-asserted-by":"crossref","unstructured":"Stoll ML , Cron RQ . Treatment of juvenile idiopathic arthritis: a revolution in care. Pediatr Rheumatol Online J 2014;12.doi:10.1186\/1546-0096-12-13","DOI":"10.1186\/1546-0096-12-13"},{"key":"2025090313523959000_5.2.e001055.2","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2016-210511"},{"key":"2025090313523959000_5.2.e001055.3","doi-asserted-by":"crossref","first-page":"294","DOI":"10.1007\/s12098-017-2293-5","article-title":"Course, outcome and complications in children with systemic onset juvenile idiopathic arthritis","volume":"84","author":"Dewoolkar","year":"2017","journal-title":"Indian J Pediatr"},{"key":"2025090313523959000_5.2.e001055.4","doi-asserted-by":"crossref","first-page":"767","DOI":"10.1016\/S0140-6736(07)60363-8","article-title":"Juvenile idiopathic arthritis","volume":"369","author":"Ravelli","year":"2007","journal-title":"The Lancet"},{"key":"2025090313523959000_5.2.e001055.5","doi-asserted-by":"publisher","DOI":"10.1002\/acr.21709"},{"key":"2025090313523959000_5.2.e001055.6","doi-asserted-by":"crossref","DOI":"10.1007\/s11926-012-0310-2","article-title":"What is the background incidence of malignancy in children with rheumatic disease?","volume":"15","author":"Mannion","year":"2013","journal-title":"Curr Rheumatol Rep"},{"key":"2025090313523959000_5.2.e001055.7","doi-asserted-by":"publisher","DOI":"10.1002\/art.27741"},{"key":"2025090313523959000_5.2.e001055.8","doi-asserted-by":"publisher","DOI":"10.1002\/art.27511"},{"key":"2025090313523959000_5.2.e001055.9","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2017-212613"},{"key":"2025090313523959000_5.2.e001055.10","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-annrheumdis-2014-206747"},{"key":"2025090313523959000_5.2.e001055.11","doi-asserted-by":"crossref","DOI":"10.1136\/rmdopen-2015-000212","article-title":"Malignancy incidence in 5294 patients with juvenile arthritis","volume":"2","author":"Zahedi Niaki","year":"2016","journal-title":"RMD Open"},{"key":"2025090313523959000_5.2.e001055.12","doi-asserted-by":"crossref","DOI":"10.1186\/1471-2407-14-634","article-title":"Population-Based cohort study on the risk of malignancy in East Asian children with juvenile idiopathic arthritis","volume":"14","author":"Kok","year":"2014","journal-title":"BMC Cancer"},{"key":"2025090313523959000_5.2.e001055.13","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.100711"}],"container-title":["RMD Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/rmdopen-2019-001055","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,3]],"date-time":"2025-09-03T20:52:49Z","timestamp":1756932769000},"score":1,"resource":{"primary":{"URL":"https:\/\/rmdopen.bmj.com\/lookup\/doi\/10.1136\/rmdopen-2019-001055"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,11]]},"references-count":13,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2019,11,13]]},"published-print":{"date-parts":[[2019,11]]}},"alternative-id":["10.1136\/rmdopen-2019-001055"],"URL":"https:\/\/doi.org\/10.1136\/rmdopen-2019-001055","relation":{},"ISSN":["2056-5933"],"issn-type":[{"value":"2056-5933","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,11]]}}}