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Cancer risk in systemic lupus: An updated international multi-centre cohort study
Journal article   Open access   Peer reviewed

Cancer risk in systemic lupus: An updated international multi-centre cohort study

Sasha Bernatsky, Rosalind Ramsey-Goldman, Jeremy Labrecque, Lawrence Joseph, Jean-Francois Boivin, Michelle Petri, Asad Zoma, Susan Manzi, Murray B. Urowitz, Dafna Gladman, …
Journal of autoimmunity, v 42, pp 130-135
01 May 2013
DOI: https://doi.org/10.1016/j.jaut.2012.12.009
PMID: 23410586
Featured in Collection :   UN Sustainable Development Goals @ Drexel
url
http://hdl.handle.net/20.500.12648/8259View
Published, Version of Record (VoR)CC BY-NC-ND V4.0,  Open

Abstract

Disease activity Epidemiology Systemic lupus erythematosus Treatment
To update estimates of cancer risk in SLE relative to the general population. A multisite international SLE cohort was linked with regional tumor registries. Standardized incidence ratios (SIRs) were calculated as the ratio of observed to expected cancers. Across 30 centres, 16,409 patients were observed for 121,283 (average 7.4) person–years. In total, 644 cancers occurred. Some cancers, notably hematologic malignancies, were substantially increased (SIR 3.02, 95% confidence interval, CI, 2.48, 3.63), particularly non-Hodgkin's lymphoma, NHL (SIR 4.39, 95% CI 3.46, 5.49) and leukemia. In addition, increased risks of cancer of the vulva (SIR 3.78, 95% CI 1.52, 7.78), lung (SIR 1.30, 95% CI 1.04, 1.60), thyroid (SIR 1.76, 95% CI 1.13, 2.61) and possibly liver (SIR 1.87, 95% CI 0.97, 3.27) were suggested. However, a decreased risk was estimated for breast (SIR 0.73, 95% CI 0.61–0.88), endometrial (SIR 0.44, 95% CI 0.23–0.77), and possibly ovarian cancers (0.64, 95% CI 0.34–1.10). The variability of comparative rates across different cancers meant that only a small increased risk was estimated across all cancers (SIR 1.14, 95% CI 1.05, 1.23). These data estimate only a small increased risk in SLE (versus the general population) for cancer over-all. However, there is clearly an increased risk of NHL, and cancers of the vulva, lung, thyroid, and possibly liver. It remains unclear to what extent the association with NHL is mediated by innate versus exogenous factors. Similarly, the etiology of the decreased breast, endometrial, and possibly ovarian cancer risk is uncertain, though investigations are ongoing. ► We studied 16,409 SLE patients, finding a slight increase in over-all cancer risk versus the general population. ► For non-Hodgkin's lymphoma, NHL the SIR was 4.39. 95% CI 3.46, 5.49). ► However, a decreased risk was estimated for breast (SIR 0.73, 95% CI 0.61–0.88) and endometrial (SIR 0.44, 95% CI 0.23–0.77) cancer.

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#3 Good Health and Well-Being

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Collaboration types
Domestic collaboration
International collaboration
Web of Science research areas
Immunology
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