Chronic Disease

Preventive care for patients with lupus could be improved

Infections and cancer are the two leading causes of death in patients with systemic lupus erythematosus (lupus), after circulatory system diseases. That's why it's important for patients with lupus, an autoimmune disease much more common in women, to get preventive cancer diagnostic tests and immunizations to prevent infections. A new study found that patients with lupus did get key preventive tests and vaccinations at rates similar to that of the general population or persons with other chronic diseases. However, patients with lupus who were younger or less educated were less likely to receive preventive services.

The researchers examined cancer surveillance (for cervical, breast, and colon cancer) and immunizations against influenza and pneumococcal diseases in patients with lupus and two comparison groups: the general population and persons with chronic conditions other than lupus. Among the women with lupus meeting the United States Preventive Services Task Force guidelines, 70 percent (vs. 73 percent for the general population) had cervical cancer screening; 70 percent (vs. 68 percent) had mammography; and 62 percent (vs. 57 percent) had colon cancer screening. Most of the women with lupus received the influenza vaccine (59 percent) and pneumococcal vaccine (60 percent), while the rates for the general population were 42 percent and 70 percent, respectively.

The study group included patients with lupus (685 women and 57 men) from the University of California–San Francisco Lupus Outcomes Study, who were interviewed about receipt of preventive services during the group's fourth annual interview (conducted between March 2005 and February 2006). They were compared with respondents to the California Health Interview Survey—a general population sample of 18,013 English-speaking individuals at least 18 years old, and a sample of 4,515 individuals with chronic illnesses (asthma, diabetes mellitus, and heart disease) other than lupus. The study was funded in part by the Agency for Healthcare Research and Quality (HS13893).

More details are in "Provision of preventive health care in systematic lupus erythematosus: Data from a large observational cohort study," Jinoos Yazdany, M.D., M.P.H., Chris Tonner, M.P.H., Laura Trupin, M.P.H., and others, in Arthritis Research & Therapy 12:R84, 2010.

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