06 September 2023

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Increased risk, prevalence of oral cancer in patients diagnosed with systemic lupus erythematosus

Lara Figini

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Systemic lupus erythematosus (SLE) is a chronic autoimmune disease with serious implications for the patient's life. It can affect different parts of the body and organs including musculoskeletal, renal, gastrointestinal, pulmonary, hematological, ocular, neural, cardiovascular and skin tissues.

The overall incidence of SLE is predominantly in females in adulthood, with more aggressive progression in younger patients. The pathological mechanism of SLE still remains unknown. Some literature studies have shown that SLE is associated with an increased risk of cancer due to cumulative exposure to immunosuppressants.

Regarding the risk of malignancy in SLE patients, there is an increased risk of non-Hodgkin's lymphoma, Hodgkin's lymphoma, myeloma, lung, liver, bladder, thyroid, stomach and brain cancers, with approximately three times greater risk of hematological malignancies in these patients than in the general population.

Materials and methods

In a systematic review published July 11 in Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, the authors assessed the risk and prevalence of oral cancer in patients with systemic lupus erythematosus (SLE) or discoid lupus erythematosus (DLE).

The review included observational cohort and cross-sectional studies that investigated the incidence or prevalence of oral cancer in adults with confirmed diagnoses of SLE or DLE.

Studies were selected based on predefined eligibility criteria, including the use of specific diagnostic criteria for SLE and DLE. After literature searches – via PubMed/Medline, Embase, Scopus, Web of Database, LILACS and LIVIVO – and gray literature for relevant studies the data selection and extrapolation process was conducted by independent reviewers.

Results

A total of 5,545 articles were identified. After screening, 8 studies met the inclusion criteria. The pooled risk estimate showed a significantly increased risk of oral cancer in patients with SLE (RR = 2.69; 95% CI, 1.75-4.16; I2 = 0%; P = 0.78) compared to the general population.

The prevalence of oral cancer in patients with DLE was found to be 10% (95% CI, 0.03-0.13; I2 = 59%; p = 0.12).

Conclusions

From the data in this review, it can be concluded that there is an elevated risk for people with SLE or DLE of developing oral cancer. The findings highlight the importance of monitoring oral mucosa in patients with these conditions.

Larissa Rosa Santana Rodrigues et al. "Risk and prevalence of oral cancer in patients with different types of lupus erythematosus: a systematic review and meta-analysis." Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology. 11 July 2023. DOI: https://doi.org/10.1016/j.oooo.2023.07.007.