No generally increased risk of cancer after total hip arthroplasty performed due to osteoarthritis

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No generally increased risk of cancer after total hip arthroplasty performed due to osteoarthritis

Hailer, Nils P. (author): Uppsala universitet,Ortopedi,Swedish Hip Arthroplasty Register, Gothenburg, Sweden

Garland, Anne (author): Uppsala universitet,Ortopedi,Swedish Hip Arthroplasty Register, Gothenburg, Sweden

Gordon, M. (author): Karolinska Institutet

Kärrholm, Johan, 1951 (author): Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för ortopedi,Institute of Clinical Sciences, Department of Orthopaedics,Swedish Hip Arthroplasty Register, Gothenburg, Sweden;Univ Gothenburg, Sahlgrenska Acad, Inst Clin Sci, Dept Orthopaed, Gothenburg, Sweden

Skoldenberg, O. (author): Karolinska Institutet

Eriksson, Niclas, 1978- (author): Uppsala universitet,Uppsala kliniska forskningscentrum (UCR)

Garmo, Hans (author): Uppsala universitet,Ortopedi,Kings Coll London, Sch Canc & Pharmaceut Sci, TOUR, London, England

Holmberg, Lars (author): Uppsala universitet,Ortopedi,Kings Coll London, Sch Canc & Pharmaceut Sci, TOUR, London, England

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2019-11-05
2020
English.
In: International Journal of Cancer. - : Wiley. - 0020-7136 .- 1097-0215. ; 147:1, s. 76-83

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Journal article (peer-reviewed)

Abstract Subject headings

Previous studies on the risk of cancer after total hip arthroplasty (THA) contradict each other, and many are hampered by small cohort sizes, residual confounding, short observation times or a mix of indications underlying the THA procedure. We evaluated the risk of cancer after total hip arthroplasty due to osteoarthritis in a nationwide cohort by comparing cancer incidences in individuals exposed to total hip arthroplasty due to osteoarthritis and in unexposed, sex-, age- and residence matched individuals. To address some previous studies' shortcomings, information on comorbidity and socioeconomic background were obtained and adjusted for. We included 126,276 patients exposed to a cemented THA between 1992 and 2012, and 555,757 unexposed individuals. Follow-up started on the day of surgery for exposed individuals and respective date for matched, unexposed individuals, and ended on the day of death, emigration, censuring or December 31st, 2012, whichever came first. The Swedish Hip Arthroplasty Registry (SHAR), the Swedish Cancer Registry, the Swedish National Patient Registry and Statistics Sweden were accessed to obtain information on procedural details of the THA, cancer diagnoses, comorbidities, and socioeconomic background. The primary outcome measure was the occurrence of any cancer after the index date. Exposed individuals had a slightly lower adjusted risk of developing any cancer than unexposed individuals (hazard ratio [HR] 0.97; CI 0.95-0.99). The only cancer with a statistically significant risk increase in exposed individuals was skin melanoma (HR 1.15; CI 1.05-1.24). We attained similar risk estimates in analyses stratified by sex, in individuals with minimum 5 years of follow-up, in an analysis including individuals with a history of previous cancer, and in patients with cementless THA. In this study on a large and well-defined population with long follow-up, we found no increased overall risk of cancer after THA. These reassuring findings could be included in the guidelines on preoperative information given to THA patients.

Subject headings

MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Ortopedi (hsv//swe)
MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Orthopaedics (hsv//eng)
MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Cancer och onkologi (hsv//swe)
MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cancer and Oncology (hsv//eng)

Keyword

total hip replacement
total hip arthroplasty
cancer
nationwide
Sweden
knee arthroplasty
follow-up
replacement
nationwide
cohort
mortality
chromium
register
nickel
cobalt
total hip replacement

Publication and Content Type

ref (subject category)
art (subject category)

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By the author/editor: Hailer, Nils P.; Garland, Anne; Gordon, M.; Kärrholm, Johan, ...; Skoldenberg, O.; Eriksson, Niclas ...; show more...; Garmo, Hans; Holmberg, Lars; show less...

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MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Clinical Medicin ...; and Orthopaedics

MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Clinical Medicin ...; and Cancer and Oncol ...

Articles in the publication: International Jo ...

By the university: University of Gothenburg; Uppsala University; Karolinska Institutet

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