Skip to main content

Advertisement

SpringerLink
Log in

Malignancies associated with systemic lupus erythematosus in Taiwan: a nationwide population-based cohort study

  • Original Article
  • Published:
Rheumatology International Aims and scope Submit manuscript

Abstract

Patients with systemic lupus erythematosus (SLE) are suggestive to have a higher cancer risk. The aim of this study is to evaluate the possible association of malignancy and SLE in Taiwan. We used the data of the National Health Insurance system of Taiwan to assess this issue. The SLE cohort contained 2,150 patients, and each patient was randomly frequency matched to 8 people without SLE on age and sex. The Cox’s proportion hazard regression analysis was conducted to estimate the effects of SLE on the cancer risk. In patients with SLE, the risk of developing overall cancer was marginally significantly higher [adjusted Hazard ratio (HR) = 1.26, 95% confidence interval (95% CI) = 0.99–1.59] and was significantly higher for developing prostate cancer (adjusted HR = 3.78, 95% CI = 1.30–11.0). Our study unexpectedly found that Taiwanese patients with SLE have a higher risk to develop prostate cancer.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Petri M (2006) Systemic lupus erythematosus and related diseases: clinical features. In: Rose NR, Mackay IR (eds) The autoimmune diseases (forth Edition). Elsevier Academic Press, London, pp 351–356

    Google Scholar 

  2. Abu-Shakra M, Urowitz MB, Gladman DD, Gough J (1995) Mortality studies in systemic lupus erythematosus. Results from a single center. II. Predictor variables for mortality. J Rheumatol 22:1265–1270

    PubMed  CAS  Google Scholar 

  3. Ruiz-Irastorza G, Khamashta MA, Castellino G, Hughes GR (2001) Systemic lupus erythematosus. Lancet 357:1027–1032

    Article  PubMed  CAS  Google Scholar 

  4. Nossent J, Cikes N, Kiss E, Marchesoni A, Nassonova V, Mosca M, Olesinska M, Pokorny G, Rozman B, Schneider M, Vlachoyiannopoulos PG, Swaak A (2007) Current causes of death in systemic lupus erythematosus in Europe, 2000–2004: relation to disease activity and damage accrual. Lupus 16:309–317

    Article  PubMed  CAS  Google Scholar 

  5. Bernatsky S, Boivin JF, Joseph L, Rajan R, Zoma A, Manzi S, Ginzler E, Urowitz M, Gladman D, Fortin PR, Petri M, Edworthy S, Barr S, Gordon C, Bae SC, Sibley J, Isenberg D, Rahman A, Aranow C, Dooley MA, Steinsson K, Nived O, Sturfelt G, Alarcón G, Senécal JL, Zummer M, Hanly J, Ensworth S, Pope J, El-Gabalawy H, McCarthy T, St Pierre Y, Ramsey-Goldman R, Clarke A (2005) An international cohort study of cancer in systemic lupus erythematosus. Arthritis Rheum 52:1481–1490

    Article  PubMed  CAS  Google Scholar 

  6. Bjornadal L, Lofstrom B, Yin L, Lundberg I, Ekbom A (2002) Increased cancer incidence in a Swedish cohort of patients with systemic lupus erythematosus. Scand J Rheumatol 31:66–71

    Article  PubMed  Google Scholar 

  7. Mellemkjaer L, Andersen V, Linet MS, Gridley G, Hoover R, Olsen JH (1997) Non-Hodgkin’s lymphoma and other cancers among a cohort of patients with systemic lupus erythematosus. Arthritis Rheum 40:761–768

    Article  PubMed  CAS  Google Scholar 

  8. Kiss E, Kovacs L, Szodoray P (2010) Malignancies in systemic lupus erythematosus. Autoimmun Rev 9:195–199

    Article  PubMed  CAS  Google Scholar 

  9. Ragnarsson O, Grondal G, Steinsson K (2003) Risk of malignancy in an unselected cohort of Icelandic patients with systemic lupus erythematosus. Lupus 12:687–691

    Article  PubMed  CAS  Google Scholar 

  10. Cibere J, Sibley J, Haga M (2001) Systemic lupus erythematosus and the risk of malignancy. Lupus 10:394–400

    Article  PubMed  CAS  Google Scholar 

  11. Abu-Shakra M, Gladman DD, Urowitz MB (1996) Malignancy in systemic lupus erythematosus. Arthritis Rheum 39:1050–1054

    Article  PubMed  CAS  Google Scholar 

  12. Pettersson T, Pukkala E, Teppo L, Friman C (1992) Increased risk of cancer in patients with systemic lupus erythematosus. Ann Rheum Dis 51:437–439

    Article  PubMed  CAS  Google Scholar 

  13. Lu JF, Hsiao WC (2003) Does universal health insurance make health care unaffordable? Lessons from Taiwan. Health Aff (Millwood) 22:77–88

    Article  Google Scholar 

  14. Gayed M, Bernatsky S, Ramsey-Goldman R, Clarke AE, Gordon C (2009) Lupus and cancer. Lupus 18:479–485

    Article  PubMed  CAS  Google Scholar 

  15. Thomas E, Brewster DH, Black RJ, Macfarlane GJ (2000) Risk of malignancy among patients with rheumatic conditions. Int J Cancer 88:497–502

    Article  PubMed  CAS  Google Scholar 

  16. Ruiz-Irastorza G, Ugarte A, Egurbide MV, Garmendia M, Pijoan JI, Martinez-Berriotxoa A, Aguirre C (2007) Antimalarials may influence the risk of malignancy in systemic lupus erythematosus. Ann Rheum Dis 66:815–817

    Article  PubMed  CAS  Google Scholar 

  17. Cancer incidence and mortality in Taiwan in (2007) Taiwan cancer registry, Department of health, executive Yuan, Taiwan, ROC

  18. Sultan SM, Ioannou Y, Isenberg DA (2000) Is there an association of malignancy with systemic lupus erythematosus? An analysis of 276 patients under long-term review. Rheumatology 39:1147–1152

    Article  PubMed  CAS  Google Scholar 

  19. Parikh-Patel A, White RH, Allen M, Cress R (2008) Cancer risk in a cohort of patients with systemic lupus erythematosus (SLE) in California. Cancer Causes Control 19:887–894

    Article  PubMed  Google Scholar 

  20. Nived O, Bengtsson A, Jönsen A, Sturfelt G, Olsson H (2001) Malignancies during follow-up in an epidemiologically defined systemic lupus erythematosus inception cohort in southern Sweden. Lupus 10:500–504

    Article  PubMed  CAS  Google Scholar 

  21. Feldman M (1987) Steroid receptor antibodies in autoimmune disorders. Biochem Biophys Res Commun 145:1342–1348

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgments

This study was supported by the National Sciences Council, Executive Yuan (grant numbers NSC 95-2625-Z-039-002, NSC 96-2625-Z-039-003, NSC 97-2625-M-039-003, NSC 98-2621-M-039-001), China Medical University Hospital (grant number 1MS1) and Taiwan Department of Health, Clinical Trial and Cancer Research Centers for Excellence (grant number DOH99-TD-B-111-004, DOH99-TD-C-111-005).

Author information

Authors and Affiliations

  1. Department of Radiation Oncology, China Medical University Hospital, Taichung, Taiwan

    Ji-An Liang

  2. School of Medicine, College of Public Health, China Medical University, Taichung, Taiwan

    Ji-An Liang, Wan-Yu Lin & Chia-Hung Kao

  3. Department of Radiation Oncology, Zuoying Armed Forces General Hospital, Kaohsiung, Taiwan

    Li-Min Sun

  4. Pingtung Christian Hospital and MeiHo University, Pingtung, Taiwan

    Jun-Jun Yeh

  5. Department of Nuclear Medicine, Taichung Veterans General Hospital, Taichung, Taiwan

    Wan-Yu Lin

  6. Institute of Radiological Science, Central Taiwan University of Science and Technology, Taichung, Taiwan

    Wan-Yu Lin

  7. Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan

    Shih-Ni Chang & Hung-Chang Sung

  8. Institute of Environmental Health, College of Public Health, China Medical University, Taichung, Taiwan

    Shih-Ni Chang & Hung-Chang Sung

  9. Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan

    Chia-Hung Kao

Authors
  1. Ji-An Liang
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Li-Min Sun
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Jun-Jun Yeh
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Wan-Yu Lin
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Shih-Ni Chang
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Hung-Chang Sung
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Chia-Hung Kao
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding authors

Correspondence to Shih-Ni Chang or Chia-Hung Kao.

Additional information

S.-N. Chang and C.-H. Kao contributed equally to this work.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Liang, JA., Sun, LM., Yeh, JJ. et al. Malignancies associated with systemic lupus erythematosus in Taiwan: a nationwide population-based cohort study. Rheumatol Int 32, 773–778 (2012). https://doi.org/10.1007/s00296-010-1684-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00296-010-1684-y

Keywords

Search

Navigation