Lung cancer in systemic lupus erythematosus

doi:10.1186/ar3949

Arthritis Res Ther. 2012; 14(Suppl 3): A15.

Published online 2012 September 27. 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 Clarke¹

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 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

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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.

Results

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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