PT  - JOURNAL ARTICLE
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
TI  - Malignancy in Pediatric-onset Systemic Lupus Erythematosus
AID  - 10.3899/jrheum.170179
DP  - 2017 Oct 01
TA  - The Journal of Rheumatology
PG  - 1484--1486
VI  - 44
IP  - 10
4099  - http://www.jrheum.org/content/44/10/1484.short
4100  - http://www.jrheum.org/content/44/10/1484.full
SO  - J Rheumatol2017 Oct 01; 44
AB  - 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.