Autoimmune rheumatologic diseases
Objective: Giant cell arteritis (GCA) is a large vessel vasculitis with persistent interferon-gamma and interleukin-12 elevation seen in temporal artery biopsies (TAB) despite glucocorticoids. These cytokines can exert anti-tumor attributes that can help protect against cancer. We evaluated the incidence of cancer in TAB-proven GCA versus non-GCA controls.
Methods: Using the Penn State electronic/pathology database from 2006-2017, we reviewed records of 100 biopsy-proven-GCA and 100 biopsy-negative non-GCA subjects (ensuring the absence of clinical GCA /other autoimmune rheumatic diseases in this control) and compared the incidence and distribution of cancer between these groups<.br />Results: GCA subjects were older than non-GCA (76.6 ± 7.2 years vs. 69 ± 10.5 years ;p< 0.001). Majority of subjects were women with no difference between the groups. Cancer was found in 8/40 (20%) GCA compared to 18/40 (45%) non-GCA (p=0.03). The median time interval from TAB to incident cancer was not significant between the 2 groups (42.5 vs 22 months; p=0.80). The GCA group had basal cell (5/8) , squamous cell (2/8) cancer and 1 fatality from lymphoblastic leukemia while the non-GCA had basal cell (1/18), squamous cell (4/18) and melanoma (2/18), breast (2/18), hematologic (2/18),1 each of prostate, lung ,colon cancer with 3 deaths from metastatic (2/18) and parotid cancer (1/18)
Conclusion: Compared to controls, GCA subjects have a lower incidence of malignancy and may have a potential anti-tumor immune response program that deserves further study