Abstract
BackgroundThis study aimed to evaluate the crude incidence rates and relative risk of malignancy in Korean patients with SLE.MethodsWe conducted a retrospective nationwide cohort study using databases from the National Health Insurance Service in Korea. All prevalent SLE patients aged over 19 were identified from January 2012 to December 2014 and observed until the diagnosis of malignancy, death, or end of the study, December 2015. The crude incidence rates (IRs) and standardised incidence ratios (SIRs) of overall and site-specific malignancies in SLE patients were estimated.ResultsWe identified 17,854 SLE patients and during the observation period (60,511 person-years [PYs]), 768 solid malignancies (126.9/10,000 PYs) and 68 haematologic malignancies (11.2/10,000 PYs) occurred in SLE patients. In SLE patients, breast and reproductive system and thyroid cancers occurred predominantly, followed by liver and colon cancers. The SIRs of overall, solid, and haematologic malignancies of SLE patients compared to the general population were 1.8 (95% confidence interval [CI] 1.6–1.9), 1.7 (95% CI 1.5–1.8), and 5.9 (95% CI 4.8–7.3), respectively. In solid malignancies, head and neck (2.7, 95% CI 1.1–4.2), bladder (2.4, 95% CI 1.1–3.8), liver (1.9, 95% CI 1.4–2.3), pancreas (1.9, 95% CI 1.3–2.6), lung (1.8, 95% CI 1.2–2.4), colon (1.7, 95% CI 1.3–2.2), thyroid (1.6, 95% CI 1.3–1.8) and breast and reproductive system (1.5, 95% CI 1.2–1.7) cancers are at increased risk in SLE patients.ConclusionAn increased risk of haematologic and solid malignancies was observed in Korean patients with SLE compared to the general population.
Highlights
This study aimed to evaluate the crude incidence rates and relative risk of malignancy in Korean patients with Systemic lupus erythematosus (SLE)
The standardised incidence ratios (SIRs) of overall, solid, and haematologic malignancies of SLE patients compared to the general popula‐ tion were 1.8 (95% confidence interval [CI] 1.6–1.9), 1.7, and 5.9, respectively
Head and neck (2.7, 95% CI 1.1–4.2), bladder (2.4, 95% CI 1.1–3.8), liver (1.9, 95% CI 1.4–2.3), pancreas (1.9, 95% CI 1.3–2.6), lung (1.8, 95% CI 1.2–2.4), colon (1.7, 95% CI 1.3–2.2), thyroid (1.6, 95% CI 1.3–1.8) and breast and reproductive system (1.5, 95% CI 1.2–1.7) cancers are at increased risk in SLE patients
Summary
Systemic lupus erythematosus (SLE) is a relatively common systemic autoimmune rheumatic disease with a wide range of clinical presentations resulting from the involvement of multiple organ systems [1,2,3,4,5]. It commonly affects young and middle-aged people and is. It was reported that patients with SLE appear to have a decreased risk of breast, endometrial and ovarian cancers [11]. Another comprehensive meta-analysis established epidemiologic evidence to support an association between SLE and increased risk for 16 cancers, except for prostate cancer and cutaneous melanoma [12]
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