RT Journal Article
SR Electronic
T1 Smoking Is the Most Significant Modifiable Lung Cancer Risk Factor in Systemic Lupus Erythematosus
JF The Journal of Rheumatology
JO J Rheumatol
FD The Journal of Rheumatology
SP 393
OP 396
DO 10.3899/jrheum.170652
VO 45
IS 3
A1 Sasha Bernatsky
A1 Rosalind Ramsey-Goldman
A1 Michelle Petri
A1 Murray B. Urowitz
A1 Dafna D. Gladman
A1 Paul R. Fortin
A1 Edward H. Yelin
A1 Ellen Ginzler
A1 John G. Hanly
A1 Christine Peschken
A1 Caroline Gordon
A1 Ola Nived
A1 Cynthia Aranow
A1 Sang-Cheol Bae
A1 David Isenberg
A1 Anisur Rahman
A1 James E. Hansen
A1 Yvan St. Pierre
A1 Ann E. Clarke
YR 2018
UL http://www.jrheum.org/content/45/3/393.abstract
AB Objective. To assess lung cancer risk in systemic lupus erythematosus (SLE), relative to demographics, drug exposures, smoking, and disease activity.Methods. We analyzed data from 14 SLE cohorts. We calculated adjusted HR estimates for lung cancer in SLE, relative to demographics, smoking, time-dependent medication exposures, and cumulative disease activity [mean adjusted SLE Disease Activity Index (SLEDAI) scores]. This project was approved by the ethics boards of all participating institutions, including the Institutional Review Board of the McGill University Health Centre. The ethics approval number for the Cancer Risk study is GEN-06-031.Results. Within these 14 SLE cohorts, 49 incident lung cancers occurred. Among lung cancer cases, 59.0% were in the highest SLEDAI quartile at baseline versus 40.8% of lung cancer–free SLE controls. The vast majority (84.2%) of SLE lung cancer cases were ever-smokers at baseline, versus 40.1% of those without lung cancer. In adjusted models, the principal factors associated with lung cancer were ever smoking (at cohort entry) and current age. Estimated adjusted effects of all drugs were relatively imprecise, but did not point toward any drug exposures as strong lung cancer risk factors.Conclusion. We saw no clear evidence for drugs as a trigger for lung cancer risk in SLE, although drug risk estimates were relatively imprecise. Smoking may be the most significant modifiable lung cancer risk factor in SLE.