Independent Cancer Risk Predictors ID'd for Sjögren Disease

Medscape

28-05-2025

TOPLINE:
Patients with Sjögren disease (SjD) had a 68% higher risk for overall malignancy than the general population, with hematologic malignancies contributing more to this elevated risk than solid tumors. Cancer accounted for 23.8% of deaths, with older age at diagnosis, smoking, lymphadenopathy, splenomegaly, and cryoglobulinemia identified as key predictors.
METHODOLOGY:
Researchers conducted a prospective study to investigate the risk for cancer among patients with SjD who met the 2002 American-European Consensus Group criteria (n = 314; mean age at inclusion, 66 years; 94.6% women) over a median follow-up of 9.5 years.
They collected information at baseline and follow-up on systemic manifestations, serological markers, disease activity scores, and treatment regimens.
They calculated standardized incidence ratios (SIRs) to compare the incidence of cancer between the study and the general population.
TAKEAWAY:
Overall, 7.01% of patients developed malignancies during follow-up; of these, 50% developed hematologic malignancies — all being non-Hodgkin lymphoma — while the remaining 50% developed solid tumors.
Patients with SjD had a 68% higher risk of developing cancer than the general population (SIR, 1.68; 95% CI, 1.68-1.69), mainly driven by a higher risk for hematologic malignancies (SIR, 3.55; 95% CI, 3.54-3.56) than for solid tumors (SIR, 1.54; 95% CI, 1.53-1.55).
Older age at diagnosis, smoking, lymphadenopathy, splenomegaly, and cryoglobulinemia were independent predictors of malignancy.
Of the 42 deaths, cancer was responsible for 23.8% of deaths, with a relative risk of 2.21 for mortality in patients with a history or new diagnosis of cancer.
IN PRACTICE:
'These findings underscore the need for early identification of high-risk patients and the refinement of risk prediction models,' the study authors wrote.
SOURCE:
This study was led by Olga Rusinovich-Lovgach, MD, Puerta de Hierro Majadahonda University Hospital, Madrid, Spain, and was published online on May 4, 2025, in Seminars in Arthritis and Rheumatism.
LIMITATIONS:
The small number of malignancies reduced statistical power, which may have prevented the evaluation of cancer-specific SIRs. The lack of a non-SjD control group may have limited the ability to differentiate disease-specific risk factors. Additionally, selection bias may be present, as patients recruited from rheumatology clinics likely had more severe disease, potentially not reflecting the broader SjD population.
DISCLOSURES:
This study received grants or industrial support from the Spanish Society of Rheumatology. One author reported receiving administrative support, article publishing charges, statistical analysis, and other ties with the Spanish Society of Rheumatology.
This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.