Cancer risk in a cohort of patients with systemic lupus erythematosus (SLE) in California

Parikh‐Patel, Arti; White, Richard; Allen, Mark S.; Cress, Rosemary D.

doi:10.1007/s10552-008-9151-8

Cited by 124 publications

(166 citation statements)

References 42 publications

(59 reference statements)

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“…On the other hand, there is a gradual increase of risk ratios of myeloid malignancies over age in SLE patients and the peak of risk ratio was observed in patients aged more than 70 years. Our findings are different from previous studies by Parikh-Patel et al 12 and Chen et al, 14 showing that the peaks of risk for haematologic malignancies may occur in mid-age and old age groups. Parikh-Patel et al 12 discovered that the risk of non-Hodgkin's lymphoma (NHL) occurred in younger SLE patients and the risks appeared to decrease with age.…”

Section: Discussioncontrasting

confidence: 99%

“…[1][2][3][4][5] Previous studies have reported higher risks of haematologic malignancies in SLE patients; however, there is a limited understanding of the aetiologies, especially age-related factors. [6][7][8][9][10][11][12] The age-risk relationship provides information on the mechanism of carcinogenesis; however, the data for haematologic malignancies and SLE remain very limited. Alarcon et al reported the increased risks of malignancies in younger SLE patients and attributed them to more aggressive treatment with immunosuppressive agents.…”

Section: Introductionmentioning

confidence: 99%

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The age-risk relationship of haematologic malignancies in female patients with systemic lupus erythematosus: a nationwide retrospective cohort study

Lin

Yen

Chang

2012

Lupus

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Background: The risks of haematologic malignancies in female patients with systemic lupus erythematosus (SLE) have been observed to be higher in young age groups than in old age groups. However, the age-risk relationship between haematologic malignancies and SLE is poorly defined. Design and methods: A retrospective cohort study was conducted nationwide with newly diagnosed SLE female patients during the period of 1997 to 2001 using the database acquired from the Taiwan National Health Research Institute. Each patient in the study was randomly frequency matched with five SLE-free people based on age. The subsequent developments of haematologic malignancies were observed until the date haematologic cancer was diagnosed or December 2008. The age-adjusted standardized incidence ratios (SIRs), the incidence per 1000 person-years, the follow-up duration to the diagnosis of haematologic malignancies and the cumulative hazard rates of haematologic malignancies between SLE and controls were analysed. Results: A total of 35 lymphoid and 14 myeloid malignancies were observed among 9349 female SLE patients. Further, significantly higher incidences of both lymphoid and myeloid malignancies were found in SLE patients (SIR: 3.30, 95% confidence interval (CI) = 2.20–4.93 and SIR: 2.86, 95% CI = 1.49–5.09). Also, two peaks of risk ratios for lymphoid malignancies were found in patients aged 21–30 years and 41–50 years. It was observed that the follow-up duration for haematologic malignancies was significantly shorter in SLE patients than in controls (73.21 vs. 105.25 months, respectively). In addition, higher cumulative hazard rates in both lymphoid and myeloid malignancies were found in SLE patients ( p < 0.0001). Conclusion: Female SLE patients have a higher incidence of haematologic malignancy in different age groups, and with shorter incubating time than SLE-free people.

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Section: Discussioncontrasting

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The age-risk relationship of haematologic malignancies in female patients with systemic lupus erythematosus: a nationwide retrospective cohort study

Lin

Yen

Chang

2012

Lupus

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“…Most prior studies did not find the increased risk of prostate cancer in patients with SLE [5][6][7]18], or even a lower risk [19]. To the best of our knowledge, there was only one earlier paper presented a significantly higher risk.…”

Section: Discussionmentioning

confidence: 80%

Malignancies associated with systemic lupus erythematosus in Taiwan: a nationwide population-based cohort study

et al. 2010

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Patients with systemic lupus erythematosus (SLE) are suggestive to have a higher cancer risk. The aim of this study is to evaluate the possible association of malignancy and SLE in Taiwan. We used the data of the National Health Insurance system of Taiwan to assess this issue. The SLE cohort contained 2,150 patients, and each patient was randomly frequency matched to 8 people without SLE on age and sex. The Cox's proportion hazard regression analysis was conducted to estimate the effects of SLE on the cancer risk. In patients with SLE, the risk of developing overall cancer was marginally significantly higher [adjusted Hazard ratio (HR) = 1.26, 95% confidence interval (95% CI) = 0.99-1.59] and was significantly higher for developing prostate cancer (adjusted HR = 3.78, 95% CI = 1.30-11.0). Our study unexpectedly found that Taiwanese patients with SLE have a higher risk to develop prostate cancer.

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“…Patients in the non-RD group who exhibited high CRP levels also displayed poorer overall survival than those with low CRP levels (5-year survival rate: 78.3% vs. 90.0%; P ¼ 0.044; (data not shown). [8][9][10][11] it remains controversial whether RD is a risk factor for solid cancers. In a meta-analysis of 21 publications reported in 2008, RA was identified as a risk factor for lymphoma and lung cancer, but the incidence of colorectal and breast cancers was lower in patients with RA.…”

Section: Resultsmentioning

confidence: 99%

Characteristics and Prognosis of Colorectal Cancer Associated With Rheumatic Disease

Kishikawa¹,

Kawai²,

Tsuno

et al. 2015

International Surgery

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It is well known that host immunity plays an important role in the defense against colorectal cancer (CRC) progression. The effects of autoimmune diseases, such as rheumatic disease (RD) in which the immune system is deregulated, on this immunity have not been fully investigated. The medical records of 1299 consecutive patients diagnosed with primary colorectal cancer who underwent surgical resection were retrospectively reviewed. The clinicopathologic factors of 28 subjects with RD (RD group) were compared with those of 1271 patients without RD (non-RD group). Compared to the non-RD group, the RD group was typified by a predominance of females (P , 0.01), older age (P , 0.01), and a lower incidence of rectal cancer (P ¼ 0.02). Although no difference was observed between the groups in terms of TNM classification, disease-free and overall survival were significantly poorer in the RD group in both univariate and multivariate analyses. Subjects who had RD for more than 10 years tended to have a higher frequency of lymph node metastasis (P ¼ 0.06) and a significantly higher incidence of synchronous distant metastasis (P ¼ 0.035) at the time of cancer diagnosis. RD was associated with a significantly poorer prognosis of colorectal cancer, suggesting that deregulation of the immune system by autoimmune diseases may adversely affect the host immune defense against colorectal cancer progression.Key words: Colorectal cancer -Rheumatic disease -Host immunity -Prognosis I t is well known that host immunity plays an important role in defenses against the development and progression of cancer. The degree of lymphocyte infiltration into tumors has been reported to correlate with improvements of patient survival.1 In carcinogen-induced mouse models of cancer, primary tumor susceptibility has been found to be enhanced in immunocompromised mice;Corresponding author: Junko Kishikawa, MD, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan. In autoimmune diseases represented by rheumatic disease (RD), the immune system loses the ability to distinguish nonself from self, eliciting an immune response against self-antigens; in this process, there is a possibility that immune defenses against nonnormal cells are lost or impaired, facilitating the development and progression of cancer. In addition, the development of RD associated with cancer has been reported, and as its development is dependent on the production of substances such as hormones, peptides, autocrine and paracrine mediators, and antibodies or the stimulation of cytotoxic lymphocytes, the condition is known as paraneoplastic rheumatic syndrome. In such cases, RD tends to be less responsive to therapy than its nonparaneoplastic equivalents, and instead, treatment of the underlying cancer usually results in regression of RD.4,5 Thus, it is postulated that RD and cancer are closely associated. However, only a few reports on the incidence and risk of cancer among patients with RD exist,6,7 and the characteristics and prognosis of colorectal cancer (CRC) in these patients remain to ...

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Cancer risk in a cohort of patients with systemic lupus erythematosus (SLE) in California

Cited by 124 publications

References 42 publications

The age-risk relationship of haematologic malignancies in female patients with systemic lupus erythematosus: a nationwide retrospective cohort study

The age-risk relationship of haematologic malignancies in female patients with systemic lupus erythematosus: a nationwide retrospective cohort study

Malignancies associated with systemic lupus erythematosus in Taiwan: a nationwide population-based cohort study

Characteristics and Prognosis of Colorectal Cancer Associated With Rheumatic Disease

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