Cancer screening in patients with systemic lupus erythematosus.
OBJECTIVE
To examine whether patients with systemic lupus erythematosus (SLE) undergo cancer screening according to established guidelines, to compare their reported screening practices with information from the general population, and to examine potential predictors of screening within our SLE sample.


METHODS
We conducted a patient survey of cancer screening practices within the Montreal General Hospital lupus cohort. We compared self-reported frequency of cancer screening to guidelines suggested for the general population, and to figures for cancer screening reported in the general population. We also developed logistic regression models to establish potential predictors of screening for patients with SLE, with cervical cancer screening being the outcome of interest in our primary analyses.


RESULTS
Of 48 women aged 50-69, 53% (95% confidence interval, CI: 38-68) had had a mammogram in the past 12 months, compared to 74% (95% CI: 73-75) for similarly aged Quebec women. Of 51 subjects aged 50 and older, only 18% (95% CI: 8-34) reported screening (fecal occult blood check with or without endoscopy) within the recommended time frame, compared to 48% (95% CI: 45-51) for colorectal screening for persons > 50 in the general population. Only 9 of 27 patients with SLE aged less than 30 had Pap tests in the past 12 months (33%, 95% CI: 19-52), compared with a general population rate of 56% (95% CI: 53-59) for similarly aged Quebec women. Our logistic regression model suggested that, among the SLE patients, non-whites, those with lower education, and those with higher disease damage scores were less likely to undergo cervical Pap testing.


CONCLUSIONS
These data suggest that appropriate cancer screening may be overlooked in patients with SLE.
Bernatsky
Sasha R
SR
Montreal General Hospital Research Institute, the Department of Rheumatology and the Divisions of Clinical Immunology and Allergy and Clinical Epidemiology, Montreal General Hospital, McGill University Health Centre, Montreal, Canada.
Cooper
Glinda S
GS
Mill
Chris
C
Ramsey-Goldman
Rosalind
R
Clarke
Ann E
AE
Pineau
Christian A
CA
D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000175:diagnosis; D015179:Colorectal Neoplasms / Q000175:diagnosis; D015897:Comorbidity; D005260:Female; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000150:complications*; D008297:Male; D008327:Mammography / Q000706:statistics & numerical data; D008403:Mass Screening / Q000379:methods; D008875:Middle Aged; D009369:Neoplasms / Q000175:diagnosis*; D017410:Practice Guidelines as Topic; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis; D014626:Vaginal Smears / Q000706:statistics & numerical data