The cancers of unidentified origin may go undiagnosed in the patients suffering from acute episodes of pericarditis, a population-based matched cohort study concludes. The study further states that the patients with acute episodes of pericarditis along with advanced age, prolong smoking, have obesity, and requiring hospitalization should be screened for cancer.
Based on a Danish study1 that concludes that after 3 months of diagnosis with pericarditis, the patients have a high risk for developing several types of cancer such as gastrointestinal cancer, lung cancer, urinary tract cancer, lymphoma, and leukemia, the authors of this study2 decided to further investigate the group of people who were benefited by screening for cancer while having acute episodes of pericarditis.
The study was a population-based cohort study in the UK. The data source for this study was Clinical Practice Research Datalink (CPRD) and Hospital Episodes Statistics (HES) databases. The study includes all the people that were diagnosed with acute pericarditis between April 1, 1998, and December 31, 2015. Acute pericarditis covers idiopathic pericarditis, pericarditis based on underlying systemic disease, and acute infectious pericarditis. Another matched cohort group who did not have any history of pericarditis was taken as a comparator. The study excluded people diagnosed with cancer before the date of pericarditis diagnosis.
The number of pericarditis patients included in the study was 6530 as compared to 26,111 people in the comparator group without pericarditis. History of connective tissue disease, recent myocardial infarction, and smoking characteristics was more in the pericarditis group than the non-pericarditis group.
The patient was followed up for a median of 2.8 years and follow-up for the comparator was for a median of 3.5 years. During the follow-up, the pericarditis patients have 728 incident cancer cases. Lung cancer was most common followed by non-Hodgkin’s lymphoma, prostate cancer, and colorectal cancer. It is important to note that approximately 50% of the cancer were diagnosed during the initial three months of the follow-up period. Age greater than 70, female, and pericardial effusion increases the risk of developing cancer during the first three-month follow-up period.
The study concludes that pericarditis may indicate hidden cancer. Although several cancers are diagnosed during acute episodes of pericarditis, there is an increased risk for certain types of cancers. The cardiologists should refer smokers, obese people, elderly, and hospitalized patients for further investigation to rule out the presence of cancer.