{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T18:58:43Z","timestamp":1785265123422,"version":"3.55.0"},"reference-count":39,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2026,1,27]],"date-time":"2026-01-27T00:00:00Z","timestamp":1769472000000},"content-version":"unspecified","delay-in-days":26,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Lupus Sci Med"],"accepted":{"date-parts":[[2025,12,29]]},"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>This study aimed to evaluate the epidemiology and predisposing factors for malignancy in lupus nephritis (LN).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective cohort study included 290 patients diagnosed with LN from 1969 to 2023. Demographic and clinical variables were analysed using the Mann-Whitney U test and Fisher\u2019s test. To identify predictors of cancer development, univariate logistic regression analysis was conducted.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Over a median follow-up period of 15 years (IQR 6\u201325), 27 malignancies were diagnosed (prevalence 9.3%, incidence 6.08 per 1000 person-years), 22.2% affecting the urinary tract and 33.3% the skin. Cancer diagnoses were evenly distributed across the decades of observation and 85.2% occurred during a quiescent phase of LN. Mortality was significantly higher in patients with malignancies compared with those without (25.9% vs 6.9%, p=0.012). Patients with malignancies were significantly older at LN diagnosis (31.6 vs 28.7 years, p=0.035) and at the end of follow-up (58.1 years vs 45.2 years, p&lt;0.001), were more frequently smokers (84.6% vs 37.7%, p=0.001) and exposed to higher cumulative doses of glucocorticoids (37.0 g vs 23.7 g, p=0.031). Univariate analysis identified smoking (OR 9.081, 95% CI 1.921 to 42.937; p&lt;0.001), older age (OR 1.058, 95% CI 1.028 to 1.089; p&lt;0.001) and higher proteinuria at LN onset (OR 1.126, 95% CI:1.024 to 1.237; p=0.016) as significant risk factors for malignancy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In patients with LN, the considerable risk of malignancy and its associated increase in mortality necessitate long-term monitoring, regardless of activity phase and disease duration. Smoking remains a major risk factor in this population, and its cessation should be actively promoted as part of patient care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/lupus-2025-001847","type":"journal-article","created":{"date-parts":[[2026,1,27]],"date-time":"2026-01-27T15:35:26Z","timestamp":1769528126000},"page":"e001847","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Malignancies in lupus nephritis: a retrospective cohort study on epidemiology and risk factors"],"prefix":"10.1136","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9254-618X","authenticated-orcid":false,"given":"Francesco","family":"Reggiani","sequence":"first","affiliation":[{"name":"Nephrology and Dialysis Unit, IRCCS Humanitas Research Hospital, Rozzano, Italy"},{"name":"Department of Biomedical Sciences, Humanitas University, Milan, 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