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Correlation between systemic lupus erythematosus and malignancies: a cross-sectional population-based study
Authors:Shir Azrielant  Shmuel Tiosano  Abdulla Watad  Naim Mahroum  Aaron Whitby  Doron Comaneshter  Arnon D Cohen  Howard Amital
Institution:1.Department of Medicine ‘B’, Zabludowicz Center for Autoimmune Diseases,Sheba Medical Center,Tel-Hashomer,Israel;2.Sackler Faculty of Medicine,Tel-Aviv University,Tel-Aviv,Israel;3.Chief Physician’s Office,Clalit Health Services,Tel-Aviv,Israel;4.Siaal Research Center for Family Medicine and Primary Care, Faculty of Health Sciences,Ben-Gurion University of the Negev,Beer-Sheva,Israel
Abstract:
Autoimmune conditions reflect dysregulation of the immune system; this may be of clinical significance in the development of several malignancies. Previous studies show an association between systemic lupus erythematosus (SLE) and the development of malignancies; however, their investigations into the development of specific malignancies are inconsistent, and their external validity may be questionable. The main objective of this study is to investigate the association between the presence of SLE and various malignancies, in a large-scale population-based study. Data for this study was collected from Clalit Health Services, the largest state-mandated health service organization in Israel. All adult members diagnosed with SLE were included (n = 5018) and their age and sex-matched controls (n = 25,090), creating a cross-sectional population-based study. Medical records of all subjects were analyzed for documentation of malignancies. Logistic regression models were built separately for each malignant condition, controlling for age, gender, BMI, smoking, and socioeconomic status. Diagnosis of malignancy (of any type) was more prevalent in the SLE population (odds ratio OR] 3.35, 95% confidence interval CI] 3.02–3.72). SLE diagnosis was also found to be independently associated with higher proportions of non-Hodgkin lymphoma (OR 3.02, 95% CI 2.72–3.33), Hodgkin lymphoma (OR 2.43, 95% CI 1.88–2.99), multiple myeloma (OR 2.57, 95% CI 1.85–3.28), cervix uteri malignancies (OR 1.65, 95% CI 1.10–2.20), and genital organ malignancies (OR 2.32, 95% CI 1.42–3.22), after adjustment for confounding variables. The presence of an SLE diagnosis was found to be independently associated with higher proportions of malignancies, particularly hematologic malignancies. These findings should be considered while treating SLE patients, and possibly supplement their screening routine.
Keywords:
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