Cancer risk in a large inception SLE cohort: Effects of demographics, smoking, and medications.

Details

• Alternative Title:
  Arthritis Care Res (Hoboken)
• Personal Author:
  Bernatsky, Sasha ; Ramsey-Goldman, Rosalind ; Urowitz, Murray B. ; Hanly, John G. ; Gordon, Caroline ; Petri, Michelle A. ; Ginzler, Ellen M ; Wallace, Daniel J ; Bae, Sang-Cheol ; Romero-Diaz, Juanita ; Dooley, Mary Anne ; Peschken, Christine A. ; Isenberg, David A ; Rahman, Anisur ; Manzi, Susan ; Jacobsen, Soren ; Lim, S. Sam ; van Vollenhoven, Ronald ; Nived, Ola ; Kamen, Diane L ; Aranow, Cynthia ; Ruiz-Irastorza, Guillermo ; Sanchez-Guerrero, Jorge ; Gladman, Dafna D. ; Fortin, Paul R. ; Alarcón, Graciela S ; Merrill, Joan T. ; Kalunian, Kenneth C ; Ramos-Casals, Manuel ; Steinsson, Kristjan ; Zoma, Asad ; Askanase, Anca ; Khamashta, Munther A. ; Bruce, Ian ; Inanc, Murat ; Clarke, Ann E
• Description:
  Objective:
  
  To assess cancer risk factors in incident SLE.
  
  Methods:
  
  Clinical variables and cancer outcomes were assessed annually among incident SLE patients. Multivariate hazard regression models (over-all risk, and most common cancers) included demographics and time-dependent medications (corticosteroids, antimalarial drugs, immunosuppressants), smoking, and adjusted mean SLE Disease Activity Index-2K.
  
  Results:
  
  Among 1668 patients (average 9 years follow-up), 65 cancers occurred: 15 breast, 10 non-melanoma skin, seven lung, six hematological, six prostate, five melanoma, three cervical, three renal, two each gastric, head and neck, and thyroid, and one each rectal, sarcoma, thymoma, and uterine cancers. Half of cancers (including all lung cancers) occurred in past/current smokers, versus one-third of patients without cancer.
  
  Conclusions:
  
  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 NMSC. Antimalarials were negatively associated with breast cancer and NMSC risk. SLE activity was associated positively with hematologic cancer and negatively with NMSC. Since the absolute number of cancers was small, additional follow-up will help consolidate these findings.
  
  
• Subjects:
  Adult Antimalarials Female Humans Immunosuppressive Agents Lupus Erythematosus, Systemic Male Middle Aged Neoplasms Risk Factors Smoking

  More +
• Source:
  Arthritis Care Res (Hoboken). 73(12):1789-1795
• Pubmed ID:
  32813314
• Pubmed Central ID:
  PMC7892637
• Document Type:
  Journal Article
• Funding:
  M01 RR000046/RR/NCRR NIH HHSUnited States/ ; UL1 RR025741/RR/NCRR NIH HHSUnited States/ ; UL1 TR001422/TR/NCATS NIH HHSUnited States/ ; U01DP005119/CC/CDC HHSUnited States/ ; U01DP005119/ACL/ACL HHSUnited States/ ; R01 AR069572/AR/NIAMS NIH HHSUnited States/ ; UL1 TR000150/TR/NCATS NIH HHSUnited States/ ; P60 AR064464/AR/NIAMS NIH HHSUnited States/ ; P60 AR048098/AR/NIAMS NIH HHSUnited States/ ; K24 AR002138/AR/NIAMS NIH HHSUnited States/ ; WT_/Wellcome TrustUnited Kingdom/
• Volume:
  73
• Issue:
  12
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:6fa01316ef7eac3e276f3c4d233cbb5103b480aff21cf23f0266ad8bfddbb200
• Download URL:
  https://stacks.cdc.gov/view/cdc/110739/cdc_110739_DS1.pdf
• File Type:
  [PDF - 91.95 KB ]