Background: Sjogren syndrome (SS) is a chronic and systemic autoimmune disease characterized by gland involvement leading to lacrimal and salivary gland dysfunction with ocular and oral dryness. Many previous studies investigated the frequency of neoplasias in SS reporting an increased risk of malignancy in these patients, especially non-Hodgkin lymphoma.

Objectives: To evaluate the prevalence of solid and haematological neoplasias in SS patients attending our outpatient clinic. Additionally, the possible predictive role of SS clinical, laboratoristic and instrumental features in development of cancer has been investigated.

Methods: We retrospectively enrolled patients classified as SS according to the 2016 classification criteria who attended the outpatient clinic at the Department of Rheumatology, University of Florence. For each patient, we collected demographic data, clinical information related to SS, laboratoristic and instrumental data and information regarding therapy. From this cohort we identified patients with diagnosis of cancer, with particular attention to those subjects with oncological disease onset after the diagnosis of SSJ.

Results: Among 394 patients with SS attending our Department, we excluded patients with diagnosis of cancer before the diagnosis of SS (30 subjects, 7.6%), enrolling only patients with SS developing neoplasia after the diagnosis of the rheumatic disease (32, 8.1%) or without history of cancer (332, 84.3%). A total of 364 SS patients were enrolled, 332 without oncological comorbidities and 32 with neoplasia. The mean age of the enrolled population was of 63.2±13.8 years old with a disease mean duration of 7.8±6.7 years and 93.1% were female. Among 32 patients with neoplasia, one subject presented two cancers, with a total number of neoplasias of 33. The most common neoplasia was breast cancer (14 patients), followed by non-melanoma skin cancers (8 patients) and uterus cervical cancer (3 patients); thyroid cancer and intraductal papillary mucinous neoplasm (IPMN) were both found in 2 patients. Finally, nasopharyngeal cancer, endometrial neoplasia, lymphoma and leukemia had the same frequency (1 patient). Comparing the clinical and laboratoristic features between the two populations (patients without vs those with cancer), a longer disease duration was associated with the onset of cancer (OR 1.09, p-value: 0.0002) as well as the presence of a lymphadenopathy with lymphoproliferative disorder that however was present in only one patient with cancer. No differences were reported in serological antibody profile or in other laboratoristic features (as leukopenia, anemia, complement consumption, hyper or hypogammaglobulinemia, cryoglobulinemia) between the two populations. Similarly, in our population, fever, fatigue and weight loss were not associated with the development of neoplasias.

Conclusion: Our findings show a high prevalence of neoplasias in SS patients, according with previous studies. In our SS population breast cancer represented the more frequent neoplasia and, contrary to what reported in the literature, hematological disorders were rare in our cohort. Additionally, the disease duration seemed to be associated with the risk of developing cancer. Our data need to be better investigated in future perspective studies, however these results highlight the need of a regular cancer screening for all SS patients, both at the diagnosis and during the follow up in order to optimize disease management and improve patient prognosis.

REFERENCES: NIL.

Acknowledgements: NIL.

Disclosure of Interests: None declared.

© The Authors 2025. This abstract is an open access article published in Annals of Rheumatic Diseases under the CC BY-NC-ND license ( http://creativecommons.org/licenses/by-nc-nd/4.0/ ). Neither EULAR nor the publisher make any representation as to the accuracy of the content. The authors are solely responsible for the content in their abstract including accuracy of the facts, statements, results, conclusion, citing resources etc.