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Arthritis Res Ther. 2012; 14(Suppl 3): A15.
Published online Sep 27, 2012. doi:  10.1186/ar3949
PMCID: PMC3467492
Lung cancer in systemic lupus erythematosus
M Kale,1 R Ramsey-Goldman,2 S Bernatsky,1 MB Urowitz,3 D Gladman,3 PR Fortin,4 M Petri,5 E Yelin,6 S Manzi,7 S Edworthy,8 O Nived,9 S-C Bae,10 D Isenberg,11 A Rahman,11 JG Hanly,12 C Gordon,13 S Jacobsen,14 E Ginzler,15 DJ Wallace,16 GS Alarcón,17 MA Dooley,18 L Gottesman,15 K Steinsson,19 A Zoma,20 J-L Senécal,21 S Barr,8 G Sturfelt,9 L Dreyer,22 L Criswell,6 J Sibley,23 JL Lee,1 and AE Clarkecorresponding author1
1McGill University Health Centre, Montreal, QC, Canada
2Northwestern University Feinberg School of Medicine, Chicago, IL, USA
3Toronto Western Hospital, Toronto, ON, Canada
4Université de Laval, QC, Canada
5Johns Hopkins University School of Medicine, Baltimore, MD, USA
6University of California, San Francisco, CA, USA
7West Penn Allegheny Health System, Pittsburgh, PA, USA
8University of Calgary, AB, Canada
9Lund University Hospital, Lund, Sweden
10The Hospital for Rheumatic Diseases, Hanyang University, Seoul, Korea
11University College, London, UK
12Dalhousie University and Capital Health, Halifax, NS, Canada
13College of Medical and Dental Sciences, University of Birmingham, UK
14Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
15State University of New York - Downstate Medical Center, Brooklyn, NY, USA
16Cedars-Sinai Medical Center/David Geffen School of Medicine, University of California Los Angeles, CA, USA
17The University of Alabama, Birmingham, AL, USA
18University of North Carolina at Chapel Hill, NC, USA
19Landspitali University Hospital, Reykjavik, Iceland
20Lanarkshire Centre for Rheumatology, Hairmyres Hospital, East Kilbride, UK
21Université de Montréal, QC, Canada
22Copenhagen University Hospital, Copenhagen, Denmark
23Royal University Hospital, Saskatoon, Saskatchewan, Canada
corresponding authorCorresponding author.
Supplement
Lupus 2012: New targets, new approaches
Peter E Lipsky, John M Esdaile, Matthew H Liang and Paul R Fortin
Conference
Lupus 2012: New targets, new approaches
27-30 September 2012
Whistler, Canada
Background
An increased lung cancer risk in SLE has been suggested in the literature [1]. Our objective was to provide an updated analyses of the lung cancer cases from a multi-site international cohort study, including descriptive statistics of the demographics (age, sex, and race/ethnicity) of cases, as well the of histology.
Methods
Data from an SLE sample of 15,980 SLE patients from 28 centers were analyzed (in Canada, the United States, the United Kingdom, Denmark, Sweden, Scotland, Korea and Iceland). Information on date of birth, sex and race was available, along with the date of SLE diagnosis. Cancer occurrence was ascertained through linkages with regional tumor registries. We assessed the demographic characteristics for all lung cancer cases in the SLE patients, and information on histology types was analyzed from the centers where this information was available.
In the current analyses, 101 lung cancer cases that had occurred after SLE diagnosis were studied. The lung cancer cases were distributed across 21 centers. The average age of the SLE patients at lung cancer diagnosis was 60 years (median 40, standard deviation (SD) 10.9). The average SLE duration at the time of lung cancer diagnosis was 13 years (median 12, SD 10.6). Race/ethnicity was not provided by six centers (35 cases). Of the remaining 66 cases, the majority were Caucasian (n = 54, 53.5%) followed by nine African-American, one Asian, one Pacific-Islander and one of unknown racial/ethnic origin. Histological lung cancer type was only provided by 12 centers (59 cases). The most common histological type reported within these 59 cases was squamous cell carcinoma (n = 15, 25.4%; 95% CI = 16.1 to 37.8) followed by adenocarcinoma (n = 13, 22%; 95% CI = 13.4 to 34.1) and nonsmall-cell carcinoma (n = 5, 8.5%; 95% CI = 3.7 to 18.4). The remaining 44% were composed of carcinomas not otherwise specified and a variety of uncommon tumors: large cell, clear cell, solid, bronchoalveolar, adenosquamous, epithelial hemangioendothelioma, oat cell, carcinoid, small cell and mucinous histological types.
Conclusion
In the general population, about 30 to 40% of lung cancer cases are adenocarcinoma, with 20 to 30% squamous cell carcinoma, and 10% large cell carcinoma [2]. Our results suggest a similar distribution, but with a possibly lower proportion of adenocarcinomas, and a higher number of uncommon lung cancer types. Further work is planned to assess other features of these cancers.
References
  • Bernatsky S, Clarke A, Petri MA. et al. Further defining cancer risk in systemic lupus: updated results in an expanded international multi-centre cohort [abstract] Arthritis Rheum. 2010;62:S731.
  • Bin J, Bernatsky S, Gordon C. et al. Lung cancer in systemic lupus erythematosus. Lung Cancer. 2007;56:303–306. doi: 10.1016/j.lungcan.2007.01.007. [PubMed] [Cross Ref]
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