The Association Between Adult IgA Vasculitis and Cancer: A Prospective Observational Study

ALOJZIJA Hocevar ^1* Vesna Jurcic ² Žiga Rotar ¹

• ¹ Department of Rheumatology, University Medical Centre Ljubljana, Ljubljana, Slovenia
• ² Institute of Pathology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia

Objectives: Cancer has been reported as a potential trigger for IgA vasculitis (IgAV) in adults; however, data on this topic are scarce. The aim of our study was to examine the frequency and location of cancer in adults with IgAV.Methods: We included 295 IgAV patients diagnosed between January 2010 and June 2021 and followed at our secondary/tertiary rheumatology centre. Cancer episodes were recorded and classified into three groups according to their temporal relation to IgAV: 1) cancer diagnosed prior to IgAV; 2) cancer diagnosed concurrently with IgAV; and 3) cancer diagnosed during IgAV follow-up. The term IgAV associated with cancer (IgAV-CA) was used for IgAV cases presenting while cancer was active or diagnosed within a three-year period before or after the IgAV diagnosis. Results: Forty-seven IgAV patients (15.9%) developed a total of 56 different cancers. Of these, 43 cancers (76.8%) preceded the IgAV diagnosis, 3 cancers (5.3%) were diagnosed concurrently with IgAV, and 10 cancers (17.9%) were diagnosed during the IgAV follow-up. Twenty-two IgAV patients (7.5%) who developed a total of 24 cancers (42.9%) could be classified as IgAV-CA cases.The three most frequently diagnosed cancers in the IgAV-CA group were prostatic, renal and bladder cancer, together accounting for 50% of cancers. Age and smoking were associated with concurrent cancers, and arthritis represented a risk factor for cancer development during IgAV follow-up.Conclusion: IgAV cases associated with cancer represent 7% of adult IgAV cases. In elderly patients, careful examination of the urogenital tract is warranted when cancer is suspected.