Objectives Joint replacement due to end-stage OA has been linked to incidence of several cancers. We aimed to estimate the association between newly diagnosed knee and hip OA and incidence of nine common cancer types. Methods We identified persons with incident knee or hip OA, aged ≥40 years, between 2009 and 2015 in the SIDIAP database in Catalonia, Spain. We matched up to three OA-free controls on age, sex and general practitioner. We followed participants from 1 year after OA diagnosis until migration, death, end of study at 31 December 2017 or incident cancer of: stomach, colorectal, liver, pancreas, lung, skin, breast, prostate and bladder. We used flexible parametric survival models, adjusted for confounders. Estimates were corrected for misclassification using probabilistic bias analysis. Results We included 117 750 persons with knee OA and matched 309 913 persons without, with mean (S.d.) age of 67.5 (11.1) years and 63% women. The hip cohort consisted of 39 133 persons with hip OA and 116 713 controls. For most of the included cancers, the hazard ratios (HRs) were close to 1. The HR of lung cancer for knee OA exposure was 0.80 (95% CI: 0.71, 0.89) and attenuated to 0.98 (0.76, 1.27) in non-smokers. The hazard of colorectal cancer was lower in persons with both knee and hip OA by 10–20%. Conclusions Knee and hip OA are not associated with studied incident cancers, apart from lower risk of colorectal cancer. The often-reported protective association of knee OA with lung cancer is explained by residual confounding.

中文翻译：

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一项大型真实世界匹配队列研究中的膝关节和髋关节骨关节炎和九种癌症的风险

目的 末期 OA 引起的关节置换与多种癌症的发病率有关。我们旨在估计新诊断的膝关节和髋关节 OA 与九种常见癌症类型的发病率之间的关联。方法 我们在西班牙加泰罗尼亚的 SIDIAP 数据库中确定了 2009 年至 2015 年间发生膝关节或髋关节 OA 的人，年龄≥40 岁。我们匹配了最多三个关于年龄、性别和全科医生的无 OA 对照。我们从 OA 诊断后 1 年开始跟踪参与者，直到 2017 年 12 月 31 日迁移、死亡、研究结束或发生以下癌症：胃癌、结直肠癌、肝癌、胰腺癌、肺癌、皮肤癌、乳腺癌、前列腺癌和膀胱癌。我们使用了灵活的参数生存模型，并针对混杂因素进行了调整。使用概率偏差分析校正错误分类的估计值。结果 我们纳入了 117 750 名膝关节 OA 患者和 309 913 名非膝关节炎患者，平均 (Sd) 年龄为 67.5 (11.1) 岁，女性占 63%。髋关节队列由 39 133 名髋关节 OA 患者和 116 713 名对照组组成。对于大多数纳入的癌症，风险比 (HRs) 接近 1。膝关节 OA 暴露的肺癌 HR 为 0.80 (95% CI: 0.71, 0.89)，在非癌症患者中衰减至 0.98 (0.76, 1.27)吸烟者。膝关节和髋关节 OA 患者患结直肠癌的风险降低 10-20%。结论 除了结直肠癌的风险较低外，膝关节和髋关节 OA 与所研究的新发癌症无关。经常报道的膝关节 OA 与肺癌的保护性关联可以通过残余混杂来解释。髋关节队列由 39 133 名髋关节 OA 患者和 116 713 名对照组组成。对于大多数纳入的癌症，风险比 (HRs) 接近 1。膝关节 OA 暴露的肺癌 HR 为 0.80 (95% CI: 0.71, 0.89)，在非癌症患者中衰减至 0.98 (0.76, 1.27)吸烟者。膝关节和髋关节 OA 患者患结直肠癌的风险降低 10-20%。结论 除了结直肠癌的风险较低外，膝关节和髋关节 OA 与所研究的新发癌症无关。经常报道的膝关节 OA 与肺癌的保护性关联可以通过残余混杂来解释。髋关节队列由 39 133 名髋关节 OA 患者和 116 713 名对照组组成。对于大多数纳入的癌症，风险比 (HRs) 接近 1。膝关节 OA 暴露的肺癌 HR 为 0.80 (95% CI: 0.71, 0.89)，在非癌症患者中衰减至 0.98 (0.76, 1.27)吸烟者。膝关节和髋关节 OA 患者患结直肠癌的风险降低 10-20%。结论 除了结直肠癌的风险较低外，膝关节和髋关节 OA 与所研究的新发癌症无关。经常报道的膝关节 OA 与肺癌的保护性关联可以通过残余混杂来解释。膝关节和髋关节 OA 患者患结直肠癌的风险降低 10-20%。结论 除了结直肠癌的风险较低外，膝关节和髋关节 OA 与所研究的新发癌症无关。经常报道的膝关节 OA 与肺癌的保护性关联可以通过残余混杂来解释。膝关节和髋关节 OA 患者患结直肠癌的风险降低 10-20%。结论 除了结直肠癌的风险较低外，膝关节和髋关节 OA 与所研究的新发癌症无关。经常报道的膝关节 OA 与肺癌的保护性关联可以通过残余混杂来解释。