Cancer Risk Factors in SLE: Multivariate Regression Analysis in 16,409 Patients

Authors

  • Sasha Bernatsky McGill University Health Centre, 687 Pine Avenue, V-Building Montreal, Quebec, H3A 1A1, Canada
  • Rosalind Ramsey-Goldman Northwestern University Feinberg School of Medicine, McGaw Pavilion. 240 E, Huron Street, Suite M-300, Chicago, Illinois, 60611-3008, USA
  • Jean-François Boivin McGill University, 1020 Pine Avenue West, Montreal, Quebec, H3A 1A2, Canada
  • Lawrence Joseph McGill University Health Centre, 687 Pine Avenue, V-Building Montreal, Quebec, H3A 1A1, Canada
  • Michelle A. Petri Johns Hopkins University School of Medicine, 1830 E Monument Street, Suite 7500, Baltimore, Maryland, 21205, USA
  • Asad Zoma Hairmyres Hospital, East Kilbride, G75 8RG, Scotland
  • Susan Manzi West Penn Allegheny Health System, Temple University, Pittsburgh, Pennsylvania, 15212, USA
  • Murray B. Urowitz Toronto Western Hospital, Toronto, Ontario, M5T 2S8, Canada
  • Dafna D. Gladman Toronto Western Hospital, Toronto, Ontario, M5T 2S8, Canada
  • Paul R. Fortin Université Laval, Service de Rheumatologie, 2705, boulevard Laurier, Local S-763, Quebec G1V 4C2, Canada
  • Ellen M. Ginzler State University of New York, Downstate Medical Center, 450 Clarkson Avenue, Box 42, Brooklyn; NY, 11203, USA
  • Edward Yelin University of California, Department of Medicine, 3333 Calif. St, Suite 270, Laurel Heights Campus, San Francisco, California, 94143, USA
  • Sang-Cheol Bae Department of Rheumatology, Hanyang University Hospital for Rheumatic Diseases, o, Seongdong-gu, Seoul, 133-792, Korea
  • Daniel J. Wallace Cedars-Sinai Medical Center/David Geffen School of Medicine at UCLA, 8387 Beverly Blvd, Suite 302, Los Angeles, California, 90048, USA
  • Steven M. Edworthy University of Calgary, 3330 Hospital Drive, NW, Calgary, Alberta, T2N 1N4, Canada
  • Soren Jacobsen Rigshospitalet, Copenhagen University Hospital, 4242, Blegdamsvej 9, 2100 Copenhagen, Denmark
  • Caroline Gordon University of Birmingham, College of Medical and Dental Sciences, Edgbaston, Birmingham, B15 2TT, UK
  • Mary A. Dooley University of North Carolina at Chapel Hill, CB #7280 3330 Thurston Building, Chapel Hill, North Carolina, 27599-7280, USA
  • Christine A. University of Manitoba, RR149 800 Sherbrook Street, Winnipeg, Manitoba, R3A1M4, Canada
  • John G. Hanly Dalhousie University and Capital Health, Second floor, 1341 Summer Street, Halifax, Nova Scotia, B3H 4K4, Canada
  • Graciela S. Alarcón The University of Alabama, Birmingham, 1520 3rd Avenue South, MT 512. Alabama, 5294-3408, USA
  • Ola Nived Lund University Hospital, S-22185 Lund, Sweden
  • Guillermo Ruiz-Irastorza Rheumatic Diseases Research Unit, Department of Medicine, Hospital de Cruces, University of the Basque Country, 48903 Bizkaia, Spain
  • David Isenberg University College, Faculty of Medicine, Department of Rheumatology, 5 University Street, London, WCIE 6JF, UK
  • Anisur Rahman University College, Faculty of Medicine, Department of Rheumatology, 5 University Street, London, WCIE 6JF, UK
  • Torsten Witte Hannover Medical School, Medicine, Carl-Neuberg-Str. 1.30625 Hannover, Germany
  • Cynthia Aranow The Feinstein Institute for Medical Research, 350 Community Drive, Manhasset, New York, 11030, USA
  • Diane L. Kamen Medical University of South Carolina, 36 Jonathan Lucas Street, Suite 912, Charleston, South Carolina 29425, USA
  • Kristján Steinsson Landspitali University Hospital, Department of Rheumatology and Center for Rheumatology Research, Fossvogur, 108 Reykjavik, Iceland
  • Anca Askanase NYU School of Medicine, Department of Medicine, New York, 10016, USA
  • Susan G. Barr University of Calgary, 3330 Hospital Drive, NW, Calgary, Alberta, T2N 1N4, Canada
  • Lindsey A. Criswell University of California, Department of Medicine, 3333 Calif. St, Suite 270, Laurel Heights Campus, San Francisco, California, 94143, USA
  • Gunnar Sturfelt Lund University Hospital, S-22185 Lund, Sweden
  • Neha M. Patel State University of New York, Downstate Medical Center, 450 Clarkson Avenue, Box 42, Brooklyn; NY, 11203, USA
  • Jean-Luc Senécal Université de Montréal, 2900 boul. Edouard-Montpetit, Montreal, Quebec, H3T 1J4, Canada
  • Michel Zummer Université de Montréal, 2900 boul. Edouard-Montpetit, Montreal, Quebec, H3T 1J4, Canada
  • Janet E. Pope University of Western Ontario, Medicine, Division of Rheumatology, 268 Grosvenor Street, London, Ontario, N6A 4V2, Canada
  • Stephanie Ensworth University of British Columbia, 317-2194 Vancouver, British Columbia, V6T 1Z3, Canada
  • Hani El-Gabalawy University of Manitoba, RR149 800 Sherbrook Street, Winnipeg, Manitoba, R3A1M4, Canada
  • Timothy McCarthy University of Manitoba, RR149 800 Sherbrook Street, Winnipeg, Manitoba, R3A1M4, Canada
  • Lene Dreyer Rigshospitalet, Copenhagen University Hospital, 4242, Blegdamsvej 9, 2100 Copenhagen, Denmark and Department of Rheumatology, Gentofte University Hospital, Hellerup, Denmark
  • Jeremy Labrecque McGill University Health Centre, 687 Pine Avenue, V-Building Montreal, Quebec, H3A 1A1, Canada
  • Yvan St. Pierre McGill University Health Centre, 687 Pine Avenue, V-Building Montreal, Quebec, H3A 1A1, Canada
  • John Sibley Royal University Hospital, Saskatoon, Saskatchewan, S7N 0W8, Canada
  • Ann E. Clarke University of Calgary, 3330 Hospital Drive, NW, Calgary, Alberta, T2N 1N4, Canada

DOI:

https://doi.org/10.12970/2310-9874.2014.02.03.4

Keywords:

 Cancer, systemic lupus erythematosus.

Abstract

Background: We assessed factors associated with cancer risk in systemic lupus erythematosus (SLE), relative to the general population, using a large international multi-centre clinical cohort (30 centres, 16,409 patients).

Methods: Cancers were ascertained by registry linkage. We used Poisson hierarchical regression to assess for potential independent effects of sex, race/ethnicity, age group, SLE duration, and calendar-year period on the standardized incidence ratios (SIR; ratio of cancers observed to expected). The hierarchical model allowed for differences in effects across countries. The primary regression analyses were done using the overall cancer SIRs; in secondary analyses we focused on hematological cancer SIRs.

Results: In adjusted analyses, 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. Regarding hematological cancers specifically, SLE duration of 5 years or more again appeared to be associated with lower SIR estimates.

Conclusion: Cancer risk in SLE is increased relative to the general population; this is particularly true for patients of white race/ethnicity, younger age, and of shorter SLE duration.

References

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Published

2014-12-05

Issue

Vol. 2 No. 3 (2014)

Section

Articles