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Volume 16 Supplement 1

Lupus 2014: New Targets, New Approaches

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Cancer risk factors in systemic lupus erythematosus: multivariate regression analysis in 16,409 patients

Arthritis Research & Therapy volume 16, Article number: A35 (2014) Cite this article

Background

Patients with systemic lupus erythematosus (SLE) experience an increased risk of cancer, which is particularly driven by hematological malignancies. Our objective was to determine whether certain factors (demographics, SLE duration and calendar year) were associated with cancer risk in SLE, relative to the general population, using a large multicenter clinical cohort.

Methods

We present detailed analyses of a multisite international SLE cohort (30 centers, 16,409 patients). Cancers were ascertained by registry linkage. Standardized incidence ratios (SIR; ratio of observed to expected cancers) were calculated for overall and for hematological cancer risk, representing the relative risk of cancer for SLE patients, versus the age, sex, and calendar-year-matched general. We used Poisson hierarchical regression to assess for potential independent effects of the factors examined (sex, race/ethnicity, age group, SLE duration, calendar-year period) on the SIRs among the SLE cohort members. The hierarchical nature of the model allowed for differences in effects from one country to the next.

Results

In adjusted analyses (Table 1), we demonstrated lower SIR estimates for overall cancer risk, in black versus white SLE patients, in SLE patients of older versus younger age, and for patients with SLE duration of 5 years or more (versus lower duration). Female sex and calendar year were not clearly associated with any differences in the SIR estimates for SLE patients. Regarding hematological cancer specifically, SLE duration of 5 years or more again appeared to be associated with lower SIR estimates.

Table 1 Results of adjusted multivariate regression to determine independent effect of variables on SIR* estimates for cancer in SLE
Full size table

Conclusions

Although cancer risk in SLE is increased relative to the general population, patients most at risk appear to be those of white race/ethnicity, younger age, and of shorter SLE duration.

Author information

Authors and Affiliations

  1. McGill University Health Centre, Montreal, QC, Canada

    Sasha Bernatsky, Lawrence Joseph & Yvan St Pierre

  2. Northwestern University Feinberg School of Medicine, Chicago, IL, USA

    Rosalind Ramsey-Goldman

  3. McGill University, Montreal, QC, Canada

    Jean-François Boivin

  4. Johns Hopkins University School of Medicine, Baltimore, MD, USA

    Michelle A Petri

  5. Hairmyres Hospital, East Kilbride, UK

    Asad Zoma

  6. West Penn Allegheny Health System, Temple University, Pittsburgh, PA, USA

    Susan Manzi

  7. Toronto Western Hospital, Toronto, ON, Canada

    Murray B Urowitz & Dafna D Gladman

  8. Université Laval, Canada

    Paul R Fortin

  9. State University of New York, Downstate Medical Center, Brooklyn, NY, USA

    Ellen M Ginzler & Neha M Patel

  10. University of California, San Francisco, CA, USA

    Edward Yelin & Lindsey A Criswell

  11. Hanyang University Hospital for Rheumatic Diseases, Seoul, Korea

    Sang-Cheol Bae

  12. Cedars-Sinai Medical Center/David Geffen School of Medicine at UCLA, Los Angeles, CA, USA

    Daniel J Wallace

  13. University of Calgary, AB, Canada

    Steven M Edworthy, Susan G Barr & Anne E Clarke

  14. Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark

    Soren Jacobsen

  15. University of Birmingham, College of Medical and Dental Sciences, Birmingham, UK

    Caroline Gordon

  16. University of North Carolina at Chapel Hill, NC, USA

    Mary A Dooley

  17. University of Manitoba, Winnipeg, MB, Canada

    Christine A Peschken, Hani El-Gabalawy & Timothy McCarthy

  18. Dalhousie University and Capital Health, Halifax, NS, Canada

    John G Hanly

  19. The University of Alabama, Birmingham, AL, USA

    Graciela S Alarcón

  20. Lund University Hospital, Lund, Sweden

    Ola Nived & Gunnar Sturfelt

  21. Rheumatic Diseases Research Unit, Bizkaia, Spain

    Guillermo Ruiz-Irastorza

  22. University College, London, UK

    David Isenberg & Anisur Rahman

  23. Hannover Medical School, Hannover, Germany

    Torsten Witte

  24. The Feinstein Institute for Medical Research, Manhasset, NY, USA

    Cynthia Aranow

  25. Medical University of South Carolina, Charleston, SC, USA

    Diane L Kamen

  26. Landspitali University Hospital, Reykjavik, Iceland

    Kristján Steinsson

  27. New York University School of Medicine, New York, NY, USA

    Anca Askanase

  28. Université de Montréal, QC, Canada

    Jean-Luc Senécal & Michel Zummer

  29. University of Western Ontario, London, ON, Canada

    Janet E Pope

  30. University of British Columbia, Vancouver, BC, Canada

    Stephanie Ensworth

Authors
  1. Sasha Bernatsky
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  2. Rosalind Ramsey-Goldman
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  3. Jean-François Boivin
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  4. Lawrence Joseph
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  5. Michelle A Petri
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  6. Asad Zoma
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  7. Susan Manzi
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  8. Murray B Urowitz
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  9. Dafna D Gladman
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  10. Paul R Fortin
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  11. Ellen M Ginzler
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  12. Edward Yelin
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  13. Sang-Cheol Bae
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  14. Daniel J Wallace
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  15. Steven M Edworthy
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  16. Soren Jacobsen
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  17. Caroline Gordon
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  18. Mary A Dooley
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  19. Christine A Peschken
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  20. John G Hanly
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  21. Graciela S Alarcón
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  22. Ola Nived
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  23. Guillermo Ruiz-Irastorza
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  24. David Isenberg
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  25. Anisur Rahman
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  26. Torsten Witte
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  27. Cynthia Aranow
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  28. Diane L Kamen
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  29. Kristján Steinsson
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  30. Anca Askanase
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  31. Susan G Barr
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  32. Lindsey A Criswell
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  33. Gunnar Sturfelt
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  34. Neha M Patel
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  35. Jean-Luc Senécal
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  36. Michel Zummer
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  37. Janet E Pope
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  38. Stephanie Ensworth
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  39. Hani El-Gabalawy
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  40. Timothy McCarthy
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  41. Yvan St Pierre
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  42. Anne E Clarke
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Corresponding author

Correspondence to Sasha Bernatsky.

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Cite this article

Bernatsky, S., Ramsey-Goldman, R., Boivin, JF. et al. Cancer risk factors in systemic lupus erythematosus: multivariate regression analysis in 16,409 patients. Arthritis Res Ther 16 (Suppl 1), A35 (2014). https://doiorg.publicaciones.saludcastillayleon.es/10.1186/ar4651

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  • DOI: https://doiorg.publicaciones.saludcastillayleon.es/10.1186/ar4651

Keywords

Arthritis Research & Therapy

ISSN: 1478-6362

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