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Accepted (AM)Open Access (License Unspecified), Open
Journal article
Cancer Risk in a Large Inception Systemic Lupus Erythematosus Cohort: Effects of Demographic Characteristics, Smoking, and Medications
Arthritis care & research (2010), v 73(12), pp 1789-1795
Dec 2021
PMID: 32813314
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Objective
To assess cancer risk factors in incident systemic lupus erythematosus (SLE).
Methods
Clinical variables and cancer outcomes were assessed annually among incident SLE patients. Multivariate hazard regression models (overall risk and most common cancers) included demographic characteristics and time‐dependent medications (corticosteroids, antimalarial drugs, immunosuppressants), smoking, and the adjusted mean Systemic Lupus Erythematosus Disease Activity Index 2000 score.
Results
Among 1,668 patients (average 9 years follow‐up), 65 cancers occurred: 15 breast, 10 nonmelanoma skin, 7 lung, 6 hematologic, 6 prostate, 5 melanoma, 3 cervical, 3 renal, 2 each gastric, head and neck, and thyroid, and 1 each rectal, sarcoma, thymoma, and uterine cancers. Half of the cancers (including all lung cancers) occurred in past/current smokers, versus one‐third of patients without cancer. Multivariate analyses indicated that overall cancer risk was related primarily to male sex and older age at SLE diagnosis. In addition, smoking was associated with lung cancer. For breast cancer risk, age was positively associated and antimalarial drugs were negatively associated. Antimalarial drugs and higher disease activity were also negatively associated with nonmelanoma skin cancer risk, whereas age and cyclophosphamide were positively associated. Disease activity was associated positively with hematologic and negatively with nonmelanoma skin cancer risk.
Conclusion
Smoking is a key modifiable risk factor, especially for lung cancer, in SLE. Immunosuppressive medications were not clearly associated with higher risk except for cyclophosphamide and nonmelanoma skin cancer. Antimalarials were negatively associated with breast cancer and nonmelanoma skin cancer risk. SLE activity was associated positively with hematologic cancer and negatively with nonmelanoma skin cancer. Since the absolute number of cancers was small, additional follow‐up will help consolidate these findings.
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Details
- Title
- Cancer Risk in a Large Inception Systemic Lupus Erythematosus Cohort: Effects of Demographic Characteristics, Smoking, and Medications
- Creators
- Sasha Bernatsky - McGill UniversityRosalind Ramsey-Goldman - Northwestern UniversityMurray B. Urowitz - Toronto Western HospitalJohn G. Hanly - Queen Elizabeth II Health Sciences CentreCaroline Gordon - University of BirminghamMichelle A. Petri - Johns Hopkins MedicineEllen M. Ginzler - SUNY Downstate Health Sciences UniversityDaniel J. Wallace - Cedars-Sinai Medical CenterSang‐Cheol Bae - Hanyang University Seoul HospitalJuanita Romero-Diaz - Instituto Nacional de Ciencias Médicas y Nutrición Salvador ZubiránMary Anne Dooley - University of North Carolina at Chapel HillChristine A. Peschken - University of ManitobaDavid A. Isenberg - University College LondonAnisur Rahman - University College LondonSusan Manzi - Allegheny Health NetworkSøren Jacobsen - Copenhagen University HospitalS. Sam Lim - Emory UniversityRonald Vollenhoven - Amsterdam University Medical CentresOla Nived - Lund UniversityDiane L. Kamen - Medical University of South CarolinaCynthia Aranow - Feinstein Institute for Medical ResearchGuillermo Ruiz-Irastorza - Hospital de CrucesJorge Sánchez-Guerrero - Toronto Western HospitalDafna D. Gladman - Toronto Western HospitalPaul R. Fortin - Université LavalGraciela S. Alarcón - University of Alabama at BirminghamJoan T. Merrill - Oklahoma Medical Research FoundationKenneth C. Kalunian - University of California, San DiegoManuel Ramos-Casals - Hospital Clínic de BarcelonaKristjan Steinsson - Reykjavík UniversityAsad Zoma - Hairmyres HospitalAnca Askanase - Columbia UniversityMunther A. Khamashta - St Thomas' HospitalIan Bruce - Manchester Academic Health Science CentreMurat Inanc - Istanbul UniversityAnn E. Clarke - University of Calgary
- Publication Details
- Arthritis care & research (2010), v 73(12), pp 1789-1795
- Publisher
- Wiley
- Number of pages
- 7
- Grant note
- Health Services and Delivery Research Programme (RR00046) Danish Rheumatism Association (A3865) Centers for Disease Control and Prevention (U01DP005119) Foundation for the National Institutes of Health (5UL1TR001422‐02, formerly 8UL1TR000150 and UL‐1RR‐; AR 69572) Republic of Korea. (NRF‐2017M3A9B4050335) Novo Nordisk Foundation Center for Basic Metabolic Research (A05990)
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- General Internal Medicine
- Web of Science ID
- WOS:000706551200001
- Scopus ID
- 2-s2.0-85115612893
- Other Identifier
- 991021933907404721
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- Collaboration types
- Domestic collaboration
- International collaboration
- Web of Science research areas
- Rheumatology