Background. Immunosuppressive therapy for antineutrophil cytoplasmic antibody-associated vasculitis has been associated with\nincreased malignancy risk. Objectives. To quantify the cancer risk associated with contemporary cyclophosphamide-sparing\nprotocols. Methods. Patients from the Norwegian Kidney Biopsy Registry between 1988 and 2012 who had biopsy-verified pauciimmune\nglomerulonephritis and positive antineutrophil cytoplasmic antibody (ANCA) serology were included. Standardised\nincidence ratios (SIRs) were calculated to compare the study cohort with the general population. Results.The study cohort included\n419 patients. During 3010 person-years, cancer developed in 41 patients (9.79%); the expected number of cancer cases was 37.5\n(8.95%). The cohort had SIRs as follows: 1.09, all cancer types (95% CI, 0.81 to 1.49); 0.96, all types except nonmelanoma skin\ncancer (95% CI, 0.69 to 1.34); 3.40, nonmelanoma skin cancer (95% CI, 1.62 to 7.14); 3.52, hematologic cancer (95% CI, 1.32 to\n9.37); 2.12, posttransplant cancer (95% CI, 1.01 to 4.44); and 1.53, during the 1ââ?¬â??5-year follow-up after diagnosis (95% CI, 1.01 to\n2.32). Conclusions. Cancer risk did not increase significantly in this cohort with ANCA-associated glomerulonephritis. However,\nincreased risk of nonmelanoma skin cancer, posttransplant cancer, and hematologic cancer indicates an association between\nimmunosuppression and malignancy.
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