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European Respiratory Journal · September 27, 2025

Incidence of malignancy after sarcoidosis diagnosis: a nationwide matched cohort study in Sweden

Elizabeth V. Arkema, Nurgul Batyrbekova, Martin Larsson, Ingrid Cecilia Glimelius, Susanna Kullberg

Nurgul Batyrbekova
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Abstract

Background: A number of studies have observed an increased risk of malignancies associated with sarcoidosis, but the exact mechanisms and whether findings are biased by diagnostic challenges remains a topic of debate. Aim: To investigate the association between sarcoidosis and incident malignancy. Methods: In a population-based cohort study in Sweden, newly diagnosed sarcoidosis patients were identified from the Patient Register (≥2 ICD coded visits), 2003-2020 (N=12 153). Malignancies were collected from the Patient and Cancer Registers. Population comparators were matched 10:1 on age, sex and residence (N=110 156). Follow-up was from 2nd ICD code/matching until 1st malignancy, emigration, death or 31 Dec 2021. Cox models estimated hazard ratios (HR) of malignancy associated with sarcoidosis. Sarcoidosis patients were stratified by treatment status at start of follow-up. Results: There were 1417 malignancies in the sarcoidosis group (10.6%) and 9694 in comparators (8.2%; median follow-up 8.9 yrs). The HR for malignancy was 1.37 (95%CI 1.29-1.44) and was highest closer to sarcoidosis diagnosis and in treated sarcoidosis patients (1.51;95%CI 1.37-1.66). The highest HRs were for Hodgkin lymphoma, non-Hodgkin lymphoma, thyroid cancer and leukaemia (Figure). Conclusions: Sarcoidosis patients have an increased risk of malignancy, especially of haematological malignancies in the years soon after sarcoidosis diagnosis. erj;66/suppl_69/PA1886/F1 F1 F1

Sarcoidosis and Beryllium Toxicity ResearchHistiocytic Disorders and TreatmentsLung Cancer Diagnosis and Treatmentsarcoidosiscancer riskcancer incidence

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