Background/Purpose: Sjögren’s disease (SjD), an autoimmune condition with chronic inflammation in exocrine glands, is associated with increased risks of cancers. The impact of cancer on mortality from SjD is not well documented. Here, we assessed trends associated with mortality from cancer in SjD across the US over a 22-year period.

Methods: This is a population-based study using a national mortality database and census data covering all U.S. residents. We calculated age-standardized mortality rates (ASMR) for cancer in SjD (SjD-C) and all-cancers, overall and by demographic variables. For comparison, we calculated ASMRs for SjD, non-Hodgkin’s lymphoma that is the commonest malignancy in SjD, and another autoimmune disease dermatopolymyositis. We performed joinpoint trend analysis to estimate annual percent change (APC) in ASMRs, and Chi-square statistics with Yates’s correction to compare changes in different cancer deaths over time.

Results: SjD was recorded as a cause of death in 7,817 decedents from 1999 through 2020. Of these, 1,395 (17.8%) had both SjD AND cancer recorded as multiple causes of death. During the same time-period, the number of all-cancer deaths was 8,096,904. The ASMRs for SjD-C initially showed a decreasing trend (p=NS), but significantly increased in the last decade at an APC of 4.04% (95% CI, 2.14-13.43; 2007-2020). In contrast, the all-cancers ASMRs decreased throughout the 22-year period. The average APC for the entire 1999-2020 was 1.54% (95% CI, 0.43-3.19) for SjD-C ASMR and -1.50% (95% CI, -1.58% to -1.46%) for all-cancer ASMRs. Mortality from dermatopolymyositis-associated cancers and non-Hodgkin’s lymphoma decreased during the study period. The SjD-C mortality rates were higher in females than males, non-Hispanic whites than other race/ethnic groups, ≥65-years old than in 0-64-years, and decedents in the West than in other census regions. Proportions of hematological cancer deaths decreased, whereas lung cancer deaths increased in SjD during the last decade.

Conclusion: In this nationwide, population-based study, cancer mortality in SjD exhibited an increasing trend in the last decade, while all-cancer mortality continually decreased. Prospective, population-based studies are needed to identify causes underlying this increase.

Trends in ASMR for SjD+cancer and all-cancers, and Ratio of SjD+cancer to all cancer Mortality Rates, 1999-2020.

Green bars indicate a statistically significant decreasing trend, Red bars indicate a statistically significant increasing trend, and White bars indicate that the trend is not statistically significant.. *p < 0.05.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/cancer-mortality-in-sjogrens-disease-disproportionate-increase-in-mortality-from-cancers-in-sjogrens-disease-relative-to-all-cancers/