Table 2.
Meta-analyses on Risk of Overall and Site-specific Malignancies in SLE Adult Patients
| Author, yr (reference) |
Studies included |
Calendar period |
Number of studies |
SLE sample size |
Patient Years |
Pooled SIR1 (95% CI) for overall risk of malignancy |
Pooled SIR1 (95% CI) for higher risk site–specific malignancies |
Pooled SIR1 (95% CI) for lower risk site–specific malignancies |
|---|---|---|---|---|---|---|---|---|
| Apor et al. 2014 [31] | [1-3, 5, 6, 8, 14, 15] | 1958–2009 | 8 | 67,929 | NR | NR | Hematologic 2.9 (2.0–4.4) HL 3.1 (2.1–4.4) Leukemia 2.3 (1.9–2.7) MM 1.5 (1.0–2.0) NHL 5.7 (3.6–9.1) |
NR |
| Bernatsky et al. 2011a [50] | [2, 5, 6, 130] | 1958–2002 | 4 | 6,068 | 38,186 | NR | NR | Prostate 0.72 (0.57–0.89) |
| Bernatsky et al. 2011b [52] | [2, 5, 6, 14, 130, 131] | 1958–2002 | 5 unique studies | 47,325 | 282,553 | NR | NR | Breast 0.76 (0.69– 0.85) Endometrial 0.71 (0.55–0.91) Ovarian 0.66 (0.49-0.90) |
| Cao et al. 2015 [25] | [1, 2, 4-9, 14-20, 23] | 1951–2009 | 16 | 59,662 | NR | RR 1.28 (1.17–1.41) | Bladder RR 2.11 (1.12–3.99) Esophageal RR 1.86 (1.21–2.88) HL RR 3.26 (2.17–4.88) Laryngeal RR 4.19 (1.98–8.87) Leukemia RR 2.01 (1.61–2.52) Liver RR 3.21 (1.70–6.05) Lung RR 1.59 (1.44–1.76) MM RR 1.45 (1.04–2.03) NHL RR 5.40 (3.75–7.77) Non–melanoma skin RR 1.51 (1.12–2.03) Thyroid RR 1.78 (1.35–2.33) Vaginal/vulvar cancer RR 3.67 (2.80–4.81) |
Skin melanoma RR 0.65 (0.50–0.85) |
| da Silva Aoki et al. 2017 [27] | [1-4, 7, 8, 11, 13, 45, 68, 129, 132-150] | 1958–2009 | 30 | 96,578 (adult and pediatric) | NR | Adult rate 4.2% (0.0318–0.0531) Pediatric rate 0.5% (0.0003–0.0154) |
NR | NR |
| Huang et al. 2014 [51] | [1-5, 7, 14, 15, 18, 19, 23] | 1951–2009 | 12 | 68,366 | NR | NR | Kidney 2.29 (1.25–4.18) | Prostate 0.77 (0.69–0.87) |
| Mao et al. 2016 [26] | [1-3, 5-8, 10, 11, 13-15, 17, 22, 23, 33, 35] | 1958–2009 | 18 | 86,069 | NR | IR 1.44 (1.23–1.69) | Anal IR 1.79 (1.50–2.14) Cervical IR 1.72 (1.02–2.93) Esophagus IR 1.64 (1.43–1.88) Head and neck IR 2.31 (1.54–3.47) Hematological (all) IR 3.36 (1.66–6.80) Kidney IR 2.00 (1.00–3.99) Leukemia IR 2.12 (1.59–2.84) Liver/Gallbladder IR 2.01 (1.52–2.65) Lung IR 1.59 (1.30–1.93) NHL IR 5.15 (2.18–12.14) Pancreas IR 1.47 (1.14–1.88) Thyroid IR 2.04 (1.50–2.77) Vagina/vulva IR 4.04 (3.00–5.43) |
Colon/rectum IR 0.83 (0.79–0.87) Ovary IR 0.72 (0.65–0.80) |
| Ni et al. 2014 [24] | [2, 5, 6, 14, 15, 33, 68] | 1958–2009 | 7 | 63,585 | 360,211 | 1.16 (1.12–1.21) | Liver 2.44 (1.46–4.05) Lung 1.68 (1.33–2.13) |
Prostate 0.71 (0.57–0.89) |
| Wu et al. 2016 [44] | [1, 2, 4-7, 9, 15, 17-19, 23] | 1958–2009 | 12 | 57,890 | NR | NR | Lung OR 1.60 (1.44–1.77) | NR |
| Zard et al. 2014 [48] | [151-157] | 2001–2012 | 7 | 416 | NR | NR | Cervical dysplasia OR 8.66 (3.75–20.00) | NR |
| Zhang et al. 2014 [46] | [1-5, 14, 19] | 1958–2009 | 7 | 66,093 | NR | NR | Thyroid 2.22 (2.11–2.34) | NR |
1
SIR standardized incidence ratio, unless otherwise specified in the table.
Abbreviations: CI, confidence interval; HL, Hodgkin’s lymphoma; IR, incidence rates; NHL, Non-Hodgkin’s lymphoma; OR, odds ratio; MM, multiple myeloma; NR, none reported; SIR, standardized incidence ratio; SMR, standardized morbidity rates; yr, year