Head and neck cancer risk in patients with rheumatoid arthritis compared with matched controls: a nationwide cohort study

OBJECTIVE: Autoimmune rheumatic diseases, including rheumatoid arthritis (RA), have recently been associated with an increased risk of cancer, particularly head and neck cancer (HNC). This study aimed to assess the risk of HNCs in patients with RA, focusing on the impact of serological status and specific HNC sites. METHODS: A retrospective cohort study was conducted using data from the Korean National Health Insurance Service. A total of 40 990 patients with RA were divided into seropositive and seronegative RA groups, matched with 204 950 non-RA controls. Cox proportional hazards models were used to calculate adjusted HRs (aHRs) for HNCs, adjusting for important covariates such as smoking, alcohol consumption and comorbidities. RESULTS: Patients with RA had an increased risk of overall HNCs (aHR: 1.53, 95% CI 1.12 to 2.09) compared with controls, with a significantly higher risk for pharyngeal cancer (aHR: 2.20, 95% CI 1.33 to 3.64). However, RA showed no significant association with oral, salivary or laryngeal cancer. The analysis stratified by seropositivity status revealed no significant difference in the risk of HNCs between seropositive and seronegative RA groups. CONCLUSION: Patients with RA have an increased risk of developing overall HNCs, particularly pharyngeal cancer. However, no significant association was found for other HNC types. Further research is warranted to better understand the potential link between RA and increased pharyngeal cancer risk.