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Cancer risk and prognosis after a hospital contact for an elevated erythrocyte sedimentation rate

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BACKGROUND: An elevated erythrocyte sedimentation rate (ESR) may be a marker of occult cancer.

METHODS: We linked Danish medical databases to examine cancer incidence in patients with a first-time hospital contact for elevated ESR during 1980-2013. We calculated standardized incidence ratios (SIRs) of cancer compared with the general population, and comorbidity-adjusted hazard ratios (aHRs) versus matched population comparisons without elevated ESR. We also compared survival among cancer patients with elevated ESR with that among cancer patients without elevated ESR.

RESULTS: During median follow-up of 4.9 years, we observed 3,926 cancers among 18,540 patients with a first-time hospital contact for elevated ESR. The risk for any cancer diagnosed during the first year following the contact for elevated ESR was 8.5% (95% CI 8.1%-8.9%). The overall 1-year cancer incidence was markedly elevated [SIR 5.3 (95% CI 5.1-5.6), aHR 5.8 (95% CI 5.4-6.3)] and was more than 3-fold elevated for most hematological cancers and for cancers of the peritoneum and connective tissue in the abdominal wall, kidney, and adrenal glands. After the first year, patients were at increased risk of developing especially hematological cancers. Patients diagnosed with cancer within 1 year after a contact for elevated ESR had poorer survival compared to matched cancer comparisons [adjusted mortality rate ratio 1.2 (95% CI 1.1-1.3)].

CONCLUSION: Elevated ESR is a strong marker of undiagnosed cancer and is associated with poorer survival.

IMPACT: Our findings may help clinicians in assessing absolute risk, common sites, and prognosis of cancers discovered after hospital contact with elevated ERS.

Original languageEnglish
JournalCancer Epidemiology, Biomarkers & Prevention
Pages (from-to)225-232
Number of pages8
Publication statusPublished - Jan 2019

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