Society of Diabetic Nephropathy Prevention Journal of Nephropathology 2251-8363 15 2 2026 03 10 Updated insights into cancer risk and pathogenesis in systemic lupus erythematosus; a nephrology viewpoint on recent evidence e27688 e27688 10.34172/jnp.2026.27688 EN Sina Salem Ahim https://orcid.org/0009-0008-2452-434X Paradise Fatehi Shalamzari https://orcid.org/0009-0000-5760-126X Faezeh Nesaei https://orcid.org/0009-0004-4495-0398 Faezeh Khajeh https://orcid.org/0000-0002-7525-2216 Seyed Amir Sheikholeslami https://orcid.org/0000-0002-0069-9785 Sara Teihou Jorshari https://orcid.org/0009-0002-1763-3392 Seyed Amir Banikarim https://orcid.org/0009-0006-0785-9020 Naeem Nikpour https://orcid.org/0000-0002-4265-5430 Journal Article 10.34172/jnp.2026.27688 2025 10 10 2025 12 05 Patients with systemic lupus erythematosus (SLE) exhibit a distinct cancer risk profile characterized by increased susceptibility to hematologic malignancies such as non-Hodgkin lymphoma (NHL), as well as certain solid tumors like lung, thyroid, and hepatobiliary cancers. Conversely, they also demonstrate a reduced risk for some cancers including breast, melanoma, and prostate cancer. This unique pattern is influenced by a combination of disease-related immune dysregulation and treatment-related factors. Additionally, immunosuppressive therapy administered in SLE management, including agents like cyclophosphamide, is known to contribute to an elevated risk of malignancies such as cervical dysplasia and certain hematologic cancers. However, specific immunosuppressants like calcineurin inhibitors have shown no significant increase in cancer incidence in some cohorts, suggesting that cancer risk is multifactorial and may depend on the type and duration of immunosuppression. However, in SLE patients, screening practices for cancers like cervical cancer are suboptimal despite their increased risk. However, some studies have found lower cervical cancer screening rates in women with SLE compared to control subjects, which influenced by factors like age, income, and comorbidities. Improved screening uptake is crucial for early cancer detection and better outcomes in this vulnerable population. Moreover, lupus nephritis enhances cancer risk and progression through complex interplay of chronic inflammation, immune dysregulation, treatment effects, and molecular pathway alterations. Inflammation-induced oxidative stress and impaired autophagy, combined with immunosuppressive therapies, provide a background for malignant transformation and decreased tumor immune surveillance.