Risk of cancer in middle-aged patients with gout: A nationwide population-based study in Korea

Objective Gout is reportedly associated with a higher incidence of cancer. However, patients with gout tend to have several cancer-related factors including obesity, smoking, and alcohol consumption, thus, the precise association between gout and cancer risk remains unclear. We aimed to investigate the risk of cancer in Korean patients with gout.

Methods Based on the Korea Health Insurance Service database, the subjects comprised patients aged 41-55 years with gout newly diagnosed between 2003 and 2007. We used a multivariable-adjusted Cox-proportional hazard model in gout patients and a 1:2 ratio for the matched controls by age, sex, and index year.

Results We compared 4,176 patients with gout with 8,352 controls. The mean age and followup duration were 48.8 years and 10.1 years in both groups. Overall cancer risk was significantly different between gout patients and controls (HR 1.224, 95% CI 1.073–1.398). The all-cause mortality (HR 1.457, 95% CI 1.149–1.847) and cancer mortality (HR 1.470, 95% CI 1.020– 2.136) were higher in gout patients. In the subgroup analysis, the cancer risk of the stomach (HR 1.710, 95% CI 1.221–2.395), head and neck (HR 1.850, 95% CI 1.071–3.196), and hematologic or lymphoid organ (HR 2.849, 95% CI 1.035–7.844) was higher in gout patients.

Conclusion Patients aged 41–55 years with gout have a higher risk of cancer and all-cause and cancer mortality compared with the general population. Therefore, special attention should be paid to higher cancer risk and mortality in these patients who are diagnosed in middle age.