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Lupus and cancer

Rheumatology Research Group, School of Immunity and Infection, University of Birmingham, Edgbaston, Birmingham, UK; Department of Rheumatology, Sandwell and West Birmingham Hospitals NHS Trust, City Hospital, Birmingham, UK

S Bernatsky

Divisions of Rheumatology and Clinical Epidemiology, McGill University Health Centre, Montreal, Quebec, Canada

R Ramsey-Goldman

Division of Rheumatology, Feinberg School of Medicine, Northwestern University, Chicago, Ill, USA

AE Clarke

Divisions of Allergy/Clinical Immunology and Clinical Epidemiology, McGill University Health Centre, Montreal, Quebec, Canada

C Gordon

Rheumatology Research Group, School of Immunity and Infection, University of Birmingham, Edgbaston, Birmingham, UK; Department of Rheumatology, Sandwell and West Birmingham Hospitals NHS Trust, City Hospital, Birmingham, UK, p.c.gordon{at}bham.ac.uk

Individuals with systemic lupus erythematosus (SLE) have an increased susceptibility to certain types of cancer. Of particular concern are haematologic malignancies, specifically non-Hodgkin lymphoma, where a three- to four-fold increased risk is seen in SLE, compared with the general population. There is some evidence that immunosuppressive exposures play a role, although there appear to be other factors driving the risk. Lupus disease activity, with resultant dysregulated lymphocyte proliferation, may itself be a mediator of the association between SLE and lymphoma. Aside from haematologic malignancy risk, lung cancer also is increased in SLE compared with the general population, and smoking likely drives this risk in large part. Last but not least, cervical dysplasia is a concern in women with SLE, particularly with exposure to immunosuppressants; routine screening for this complication should not be neglected.

Key Words: cancer • malignancy • non-Hodgkin lymphoma • systemic lupus erythematosus

Lupus, Vol. 18, No. 6, 479-485 (2009)
DOI: 10.1177/0961203309102556


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