Background/Purpose: Systemic lupus erythematosus (SLE) is a chronic autoimmune disease that increases vulnerability to malignancy and premature mortality. Understanding long-term trends and disparities in SLE-related cancer deaths is essential for guiding equitable public health strategies.

Methods: A retrospective population-based analysis was performed utilizing the Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research (CDC WONDER) database. Age-adjusted mortality rates (AAMR) per 1,000,000 individuals were extracted and calculated the annual percentage change (APC) through Joinpoint regression The data were stratified to evaluate temporal trends and disparities based on sex, race, and geographic region in systemic lupus erythematosus (SLE)-related cancer mortality among adults.

Results: From 1999 to 2020, a total of 2,642 cancer-related deaths among adults aged ≥25 years with SLE were recorded in the United States. The overall AAMR for SLE-associated cancer mortality rose from 0.58 [95% CI: 0.46–0.69] in 1999 to 0.69 [95% CI: 0.59–0.79] in 2020. A period of stability was observed between 1999 and 2016 (APC: -1.00; 95% CI: -2.09–0.09; p=0.07), followed by a significant increase from 2016 to 2020 (APC: 10.71; 95% CI: 1.91–20.27; p=0.02). Sex-based disparities were evident, with females exhibiting a markedly higher AAMR [0.83; 95% CI: 0.79–0.87] compared to males [0.22; 95% CI: 0.20–0.24]. Racial disparities were also pronounced, with non-Hispanic (NH) Black or African American individuals experiencing double the AAMR [1.03] of NH White individuals [0.49]. Regionally, the Western United States reported the highest AAMR [0.59; 95% CI: 0.54–0.64], while the Northeast had the lowest [0.43; 95% CI: 0.39–0.47]. Additionally, nonmetropolitan areas demonstrated higher mortality rates [0.59; 95% CI: 0.53–0.64] compared to large metropolitan areas [0.54; 95% CI: 0.52–0.56].

Conclusion: Emerging data highlight a rising trend in SLE-associated cancer mortality, particularly in recent years, alongside marked disparities by sex, race, and geography. These findings underscore the urgent need for tailored, population-level interventions to mitigate inequities and improve outcomes in vulnerable populations.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/unraveling-disparities-in-systemic-lupus-erythematosus-related-mortality-among-u-s-adults-%e2%89%a525-years-with-malignancy-a-longitudinal-analysis-of-gender-race-and-geographic-inequities-using/