TY - JOUR T1 - Malignancy in Pediatric-onset Systemic Lupus Erythematosus JF - The Journal of Rheumatology JO - J Rheumatol DO - 10.3899/jrheum.170179 SP - jrheum.170179 AU - Sasha Bernatsky AU - Ann E. Clarke AU - Omid Zahedi Niaki AU - Jeremy Labrecque AU - Laura E. Schanberg AU - Earl D. Silverman AU - Kristen Hayward AU - Lisa Imundo AU - Hermine I. Brunner AU - Kathleen A. Haines AU - Randy Q. Cron AU - Kiem Oen AU - Linda Wagner-Weiner AU - Alan M. Rosenberg AU - Kathleen M. O’Neil AU - Ciarán M. Duffy AU - Emily von Scheven AU - Lawrence Joseph AU - Jennifer L. Lee AU - Rosalind Ramsey-Goldman Y1 - 2017/08/01 UR - http://www.jrheum.org/content/early/2017/07/26/jrheum.170179.abstract N2 - Objective To determine cancer incidence in a large pediatric-onset systemic lupus erythematosus (SLE) population. Methods Data were examined from 12 pediatric SLE registries in North America. Patients were linked to their regional cancer registries to detect cancers observed after cohort entry, defined as date first seen in the clinic. The expected number of malignancies was obtained by multiplying the person-years in the cohort (defined from cohort entry to end of followup) by the geographically matched age-, sex-, and calendar year–specific cancer rates. The standardized incidence ratio (SIR; ratio of cancers observed to expected) was generated, with 95% CI. Results A total of 1168 patients were identified from the registries. The mean age at cohort entry was 13 years (SD 3.3), and 83.7% of the subjects were female. The mean duration of followup was 7.6 years, resulting in a total observation period of 8839 years spanning the calendar period 1974–2009. During followup, fourteen invasive cancers occurred (1.6 cancers per 1000 person-yrs, SIR 4.13, 95% CI 2.26–6.93). Three of these were hematologic (all lymphomas), resulting in an SIR for hematologic cancers of 4.68 (95% CI 0.96–13.67). SIR were increased for both male and female patients, and across age groups. Conclusion Although cancer remains a relatively rare outcome in pediatric-onset SLE, our data do suggest an increase in cancer for patients followed an average of 7.6 years. About one-fifth of the cancers were hematologic. Longer followup, and study of drug effects and disease activity, is warranted. ER -