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Risk of malignancy in patients with systemic lupus erythematosus: Systematic review and meta-analysis
- Source :
- Seminars in Arthritis and Rheumatism. 51:1230-1241
- Publication Year :
- 2021
- Publisher :
- Elsevier BV, 2021.
-
Abstract
- Background Malignancy is a potential comorbidity in patients with systemic lupus erythematosus (SLE). However, risk by malignancy type remains to be fully elucidated. We evaluated the risk of malignancy type in SLE patients in a systematic review and meta-analysis. Methods MEDLINE and EMBASE were searched from inception to July 2018 to identify observational studies that evaluated malignancy risk in adult SLE patients compared with the general population. Random-effects models were used to calculate pooled risk ratios (RRs) and 95% confidence intervals (CIs). Heterogeneity was quantified using the I2 test. Findings Forty-one studies reporting on 40 malignancies (one overall, 39 site-specific) were included in the meta-analysis. The pooled RR for all malignancies from 3694 events across 80 833 patients was 1.18 (95% CI: 1.00-1.38). The risk of 24 site-specific malignancies (62%) was increased in SLE patients. For malignancies with ≥6 studies, non-Hodgkin lymphoma and Hodgkin lymphoma risk was increased >3-fold; myeloma and liver >2-fold; cervical, lung, bladder, and thyroid ≥1.5-fold; stomach and brain >1.3-fold. The risk of four malignancies (breast, uterine, melanoma, prostate) was decreased, whereas risk of 11 other malignancies did not differ between SLE patients and the general population. Heterogeneity ranged between 0% and 96%, and 63% were non-significant. Interpretation The risk of overall and some site-specific malignancies is increased in SLE compared with the general population. However, the risk for some site-specific malignancies is decreased or did not differ. Further examination of risk profiles and SLE patient phenotypes may support guidelines aimed at reducing malignancy risk. Funding AstraZeneca. Systematic review registration PROSPERO number: CRD42018110433.
- Subjects :
- Male
Risk
Oncology
medicine.medical_specialty
Population
Malignancy
Rheumatology
Risk Factors
immune system diseases
Neoplasms
Internal medicine
Odds Ratio
medicine
Humans
Lupus Erythematosus, Systemic
education
education.field_of_study
business.industry
Cancer
medicine.disease
Comorbidity
Confidence interval
Lymphoma
Anesthesiology and Pain Medicine
Meta-analysis
Relative risk
business
Subjects
Details
- ISSN :
- 00490172 and 42018110
- Volume :
- 51
- Database :
- OpenAIRE
- Journal :
- Seminars in Arthritis and Rheumatism
- Accession number :
- edsair.doi.dedup.....9a199945e877149babf8b412fa7c721c