Cancer Diagnosis in a Cohort of Patients with Sjogren's Syndrome and Rheumatoid Arthritis: A Single-center Experience and Review of the Literature

Background: With the development of modern therapies and better care of patients with autoimmune rheumatic diseases (ARTDs) increased survival has been achieved. However, ARDs may share an association with risk of lymphomas and solid tumors. The increased cancer risk in these patients is mainly due to high inflammatory activity and severity of disease, rather than the immunosuppressive therapy. Patients and Methods: We studied the coexistence or later development of cancer with ARDs in a retrospective audit of a reference university hospital and critically reviewed published literature. Fourteen out of 1,730 patients with rheumatoid arthritis (RA) and Sjogren's syndrome (SS) followed-up at the University Hospital of Ioannina over the last 33 years developed secondary malignancies, both solid tumors and lymphomas. Results and Conclusion: The most frequent cancer associated with ARDs is diffuse large B-cell lymphoma (DLBCL). The average risk of lymphoma in RA may be composed of a markedly increased risk in patients with most severe disease. Solid tumors were presented mainly in RA patients and renal cell carcinoma was the most frequently found.