Cancers to Be Aware of in Lupus
Cancers to Be Aware of in Lupus
Dreyer L, Faurschou M, Mogensen M, Jacobsen S
Arthritis Rheum. 2011;63:3032-3037
Morbidity in systemic lupus erythematosus (SLE) can be from multiple causes, including direct disease-related injury, infections, drug toxicity, vascular disease, and malignancies. Dreyer and colleagues investigated the incidence of potentially viral-related malignancies in patients with SLE. A cohort of 576 patients with SLE were followed prospectively for approximately 7800 person-years as part of a multicenter study based in Denmark. Their median age at onset of SLE was 33 years, 88% were women, and 96% were white. Incident cancers in these patients were identified using national databases, and standardized incidence ratios (SIRs) of cancers in these patients were calculated by comparing their rates of specific cancers with the rates in the general population.
Overall, 61 cancers occurred in the patients with SLE, compared with a rate of approximately 38 expected cancers in the general population (SIR, 1.6). Twenty-nine of these 61 cancers were presumed to be related to viruses; these included human papilloma virus (HPV)-associated cancers (cervical, anal, vaginal/vulvar, and nonmelanoma skin cancers in which HPV has been implicated) as well as liver cancer, Hodgkins and non-Hodgkin's lymphoma, and bladder cancer (bladder cancer has been attributed to polyomavirus). In particular, the SIRs of anal, vaginal/vulvar and nonmelanoma skin cancers were significantly elevated (26.9, 9.1, and 5.9, respectively; lower bounds of the 95% confidence limits were all > 1). However, although not statistically significant, the SIR of cervical cancer implied lower risk in patients with SLE (SIR, 0.6; 95% confidence interval, 0.1-4.5).
The investigators concluded that patients in this cohort were at increased risk for potentially viral-related malignancies, especially those associated with HPV infections.
High Incidence of Potentially Virus-Induced Malignancies in Systemic Lupus Erythematosus: A Long-term Follow-up Study in a Danish Cohort.
Dreyer L, Faurschou M, Mogensen M, Jacobsen S
Arthritis Rheum. 2011;63:3032-3037
Study Summary
Morbidity in systemic lupus erythematosus (SLE) can be from multiple causes, including direct disease-related injury, infections, drug toxicity, vascular disease, and malignancies. Dreyer and colleagues investigated the incidence of potentially viral-related malignancies in patients with SLE. A cohort of 576 patients with SLE were followed prospectively for approximately 7800 person-years as part of a multicenter study based in Denmark. Their median age at onset of SLE was 33 years, 88% were women, and 96% were white. Incident cancers in these patients were identified using national databases, and standardized incidence ratios (SIRs) of cancers in these patients were calculated by comparing their rates of specific cancers with the rates in the general population.
Overall, 61 cancers occurred in the patients with SLE, compared with a rate of approximately 38 expected cancers in the general population (SIR, 1.6). Twenty-nine of these 61 cancers were presumed to be related to viruses; these included human papilloma virus (HPV)-associated cancers (cervical, anal, vaginal/vulvar, and nonmelanoma skin cancers in which HPV has been implicated) as well as liver cancer, Hodgkins and non-Hodgkin's lymphoma, and bladder cancer (bladder cancer has been attributed to polyomavirus). In particular, the SIRs of anal, vaginal/vulvar and nonmelanoma skin cancers were significantly elevated (26.9, 9.1, and 5.9, respectively; lower bounds of the 95% confidence limits were all > 1). However, although not statistically significant, the SIR of cervical cancer implied lower risk in patients with SLE (SIR, 0.6; 95% confidence interval, 0.1-4.5).
The investigators concluded that patients in this cohort were at increased risk for potentially viral-related malignancies, especially those associated with HPV infections.
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