Exploring the Links Between Systemic Lupus Erythematosus and Cancer - 17/08/11

Doi : 10.1016/j.rdc.2005.01.002

Sasha Bernatsky, MD, MSc ^a, Rosalind Ramsey-Goldman, MD, DrPH ^b, Ann Clarke, MD, MSc ^a,⁎
^a Division of Clinical Epidemiology, Montreal General Hospital, 1650 Cedar Avenue, Room L10-520, Montreal, QC H3G 1A4, Canada
^b Division of Rheumatology, Department of Medicine, Feinburg School of Medicine, Northwestern University, 240 East Huron Street, McGaw Pavilion 2300, Chicago, IL 60611, USA

^*Corresponding author

Résumé

For decades, concern has been mounting that individuals with systemic lupus erythematosus (SLE) have increased susceptibility to cancer. Recent data confirm that certain cancers, particularly hematologic, occur more frequently in SLE than in the general population. Numerous pathogenic mechanisms are possible, but hypotheses remain largely speculative. In particular, data are inadequate on how cancer risk in SLE may be related to medication exposures. To evaluate the impact of medication exposures on cancer risk in SLE, cooperative efforts of Systemic Lupus International Collaborating Clinics and Canadian Network for Improved Outcomes in Systemic Lupus are currently in progress. This should provide much-needed insight into the pathogenesis of the association between cancer and SLE.

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Plan

Review of cancer risk in systemic lupus erythematosus

Hematologic malignancies

Other tumors

Is surveillance bias a concern?

Etiology of cancer risk in systemic lupus erythematosus

Lifestyle cancer risk factors in systemic lupus erythematosus: smoking and obesity

Medications and cancer in systemic lupus erythematosus

Potential interactions between medications and viral exposures

Possible clinical characteristics important in systemic lupus erythematosus–related malignancy

Geographic variations and race/ethnicity in cancer risk

Genetic factors and their place in the pathways between autoimmunity and non-Hodgkin's lymphoma

Recommendations for cancer screening

Summary

The authors would like to acknowledge the following grant support: (S.B.) Canadian Institutes of Health Research (CIHR)/Lupus Canada Fellowship, Canadian Arthritis Network Fellowship, and Lupus Manitoba; R.R.-G) Arthritis Foundation, Clinical Science Grant, Arthritis Foundation Greater Chicago Chapter National Institutes of Health Grants AR 02138 and AR 48098, and Lupus Foundation of Illinois Chapter Grant; and (A.C.) National Cancer Institute of Canada grants CIHR 013135 and 10005, TAS 99105, Singer Family Fund for Lupus Research, and CIHR Investigator Award.