Systemic lupus and malignancies

Purpose of review: Individuals with systemic lupus erythematosus (SLE) have an increased susceptibility to certain types of cancer. Given concerns focused on this issue, we present a review of this important topic. Recent findings: In non-Hodgkin lymphoma (NHL), a several-fold increased risk is seen in SLE versus the general population. It has long been suspected that immunosuppressive drugs play a role in this risk, but there may be other important driving factors as well. Lupus disease activity may itself heighten the risk of lymphoma in diseases like SLE. Lung cancer risk also is increased in SLE; smoking appears to drive this risk. Additionally, cervical dysplasia risk is increased in SLE, particularly with immunosuppressive drug exposure. An altered clearance of cancer-related viral agents in SLE (due to the disease and/or immunosuppression) may contribute to this risk and may also drive the risk for other cancers (such as vulvovaginal and hepatic carcinomas) in SLE. On the positive side, one new and significant finding is that SLE patients seem to have a decreased risk of certain nonhematologic cancers (breast, ovarian, endometrial, and prostate). Summary: Though much has been learnt so far regarding the risk in SLE, much yet remains unknown.