Malignancies in systemic lupus erythematosus: an update.

Abstract

Patients with systemic lupus erythematosus (SLE) have altered incidences of certain malignancies as compared with the general population. This review summarizes the recent literature on risk of malignancy in SLE and proposed mechanisms for these altered susceptibilities. Recent studies have confirmed previous data showing an increased risk of hematological, lung, thyroid, liver, cervical and vulvovaginal cancers, while demonstrating a decreased risk of breast and prostate cancer. Lymphomagenesis in SLE has been linked to increased activity of multiple inflammatory cytokines as well as possible viral causes. The decreased rates of hormone-sensitive cancers, such as breast and prostate is speculated to be related to the presence of lupus autoantibodies and downregulation of certain proteins in SLE. This knowledge has been utilized to investigate new therapeutic modalities for these malignancies. Recent data confirm previously reported altered malignancy rates in SLE. There has been some elucidation of mechanisms underlying cancer development in SLE, although additional work is yet to be done.