TY - JOUR
T1 - Incidence of malignancies in patients with multiple sclerosis versus a healthy matched cohort
T2 - A population-based cohort study in the Netherlands using the PHARMO Database Network
AU - Kuiper, Josephina G.
AU - Overbeek, Jetty A.
AU - Foch, Caroline
AU - Boutmy, Emmanuelle
AU - Sabidó, Meritxell
N1 - Funding Information: This study was sponsored by Merck (CrossRef Funder ID: 10.13039/100009945), who provided financial support for the conduct of the research and preparation of the article. Merck Healthcare KGaA, Darmstadt, Germany, in collaboration with all authors, was involved in the study design; in the collection, analysis and interpretation of data; in the writing of the report; and in the decision to submit the article. Funding Information: Medical writing assistance was provided by Farah Johnson-May and Ella Palmer of inScience Communications, Springer Healthcare Ltd, Chester, UK, and was funded by Merck Healthcare KGaA, Darmstadt, Germany. The authors would like to thank all the healthcare providers contributing information to the PHARMO Database Network. Funding Information: Medical writing assistance was provided by Farah Johnson-May and Ella Palmer of inScience Communications, Springer Healthcare Ltd, Chester, UK, and was funded by Merck Healthcare KGaA, Darmstadt, Germany. The authors would like to thank all the healthcare providers contributing information to the PHARMO Database Network. Statement of ethics, The PHARMO Institute uses de-identified data from existing databases without any direct enrollment of subjects. Ethical approval or informed consent is not necessary according to the Dutch law regarding human medical scientific research (Wet Medisch-wetenschappelijk Onderzoek met mensen (WMO)), which is enforced by the Central Committee of Research involving Human Subjects (Centrale Commissie Mensgebonden Onderzoek (CCMO)). Studies performed on the PHARMO Database Network are reviewed afterwards by the PHARMO Compliance Committee to assess whether the WMO requirements are met. This procedure has been effective since the start of the PHARMO Institute in December 1999. This also applies for the study entitled “Cancer in MS in the Netherlands” performed by the PHARMO Institute for Merck KGaA for which data extraction started in March 2017.”, This study was sponsored by Merck (CrossRef Funder ID: 10.13039/100009945), who provided financial support for the conduct of the research and preparation of the article. Merck Healthcare KGaA, Darmstadt, Germany, in collaboration with all authors, was involved in the study design; in the collection, analysis and interpretation of data; in the writing of the report; and in the decision to submit the article. All authors conceived and designed the analysis, contributed data and analysis tools and wrote the paper/interpreted results. Publisher Copyright: © 2022 The Authors
PY - 2022/9/1
Y1 - 2022/9/1
N2 - This study estimated the incidence of malignancy in patients with multiple sclerosis (MS) versus a matched general population cohort in the Netherlands. Adults with a diagnosis of MS between 2006 and 2014 in the General Practitioner (GP) Database of the PHARMO Database Network with ≥ 1 year of patient history were matched to four non-MS individuals based on year of birth, sex, and GP practice. Patients were followed-up until the earliest malignancy diagnosis, death, or end of data collection. Age-adjusted incidence rates (IR) were measured overall and by cancer type. Standardized incidence ratios (SIR) were calculated as the ratio of stratification-specific IRs in the MS and non-MS cohorts. A total of 1,692 MS patients were matched to 6,768 non-MS patients. Age-adjusted IR of any malignancy, excluding non-melanoma skin cancer (n = 27), in the MS cohort was 48.3 (95%CI:30.1–66.5) per 10,000 PY. An increased incidence of any malignancy was observed in the MS cohort versus the non-MS cohort (SIR 1.8 [95%CI:1.1–2.5]). The most commonly observed malignancies in the MS cohort were breast cancer (n = 8; IR 20.4 [95%CI:6.3–34.5] per 10,000 PY) and melanoma (n = 6; IR 14.8 [95%CI:3.0–26.7] per 10,000 PY). The corresponding SIR observed between cohorts was 1.4 (95%CI:0.4–2.4) and 3.4 (95%CI:0.7–6.2), respectively. While the small increased incidence of malignancy in the MS cohort could be an artefact created by a different distribution of risk factors, an increased incidence of malignancy in MS patients in the Netherlands cannot be excluded.
AB - This study estimated the incidence of malignancy in patients with multiple sclerosis (MS) versus a matched general population cohort in the Netherlands. Adults with a diagnosis of MS between 2006 and 2014 in the General Practitioner (GP) Database of the PHARMO Database Network with ≥ 1 year of patient history were matched to four non-MS individuals based on year of birth, sex, and GP practice. Patients were followed-up until the earliest malignancy diagnosis, death, or end of data collection. Age-adjusted incidence rates (IR) were measured overall and by cancer type. Standardized incidence ratios (SIR) were calculated as the ratio of stratification-specific IRs in the MS and non-MS cohorts. A total of 1,692 MS patients were matched to 6,768 non-MS patients. Age-adjusted IR of any malignancy, excluding non-melanoma skin cancer (n = 27), in the MS cohort was 48.3 (95%CI:30.1–66.5) per 10,000 PY. An increased incidence of any malignancy was observed in the MS cohort versus the non-MS cohort (SIR 1.8 [95%CI:1.1–2.5]). The most commonly observed malignancies in the MS cohort were breast cancer (n = 8; IR 20.4 [95%CI:6.3–34.5] per 10,000 PY) and melanoma (n = 6; IR 14.8 [95%CI:3.0–26.7] per 10,000 PY). The corresponding SIR observed between cohorts was 1.4 (95%CI:0.4–2.4) and 3.4 (95%CI:0.7–6.2), respectively. While the small increased incidence of malignancy in the MS cohort could be an artefact created by a different distribution of risk factors, an increased incidence of malignancy in MS patients in the Netherlands cannot be excluded.
KW - Epidemiology
KW - Incidence
KW - Malignancy
KW - Melanoma
KW - Multiple sclerosis
KW - Observational study
KW - PHARMO
UR - http://www.scopus.com/inward/record.url?scp=85133924756&partnerID=8YFLogxK
U2 - https://doi.org/10.1016/j.jocn.2022.06.025
DO - https://doi.org/10.1016/j.jocn.2022.06.025
M3 - Article
C2 - 35810606
SN - 0967-5868
VL - 103
SP - 49
EP - 55
JO - Journal of clinical neuroscience
JF - Journal of clinical neuroscience
ER -