TL;DR
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Research on cancer risk in people with sickle cell disease has produced mixed results, with some studies finding higher rates of blood cancers and others reporting no overall increase. Newer, more sensitive research into clonal hematopoiesis may help explain the findings, but it does not establish that SCD causes cancer.
Studies of cancer risk in sickle cell disease (SCD) remain inconsistent: some population research points to more cancers, particularly blood cancers, while other studies find no overall increase or lower rates of solid tumors. A MedPage Today report published October 15, 2026, says newer laboratory studies of clonal hematopoiesis may offer clues, but researchers have not established a clear causal link or a reliable estimate of risk.
Population studies have reached different conclusions. A study of more than 7,500 patients in Britain reported about twice the risk of any malignancy compared with its reference population, including several blood cancers and solid tumors. In contrast, a California study of 6,400 patients found lower overall cancer risk, alongside a 72% higher risk of leukemia and a 38% lower risk of solid malignancies. A case-control study of 1,300 patients found no overall increase and only a marginally higher risk of blood cancers. These estimates come from different study designs and populations, so they are not directly interchangeable.
A systematic review covering about 24,000 people worldwide found widely varying risk estimates, while its overall analysis indicated increased malignancy risk in SCD and thalassemia, particularly for blood cancers and myeloid leukemia in SCD. Other researchers have argued that the relative risk in SCD is lower than in recognized cancer-predisposition syndromes. The report also describes a study finding no significant overall cancer association with sickle cell trait, which is distinct from SCD.
Laboratory research has raised clonal hematopoiesis as one possible avenue for understanding the cancer findings. The process occurs when acquired mutations give some blood stem cells a growth advantage, producing expanding cell populations. A newer, more sensitive assay found four times higher odds of clonal hematopoiesis in two cohorts of children with SCD than in matched controls. That result concerns a possible biological marker, not proof that those children will develop cancer or that SCD directly causes malignancy.
Interpreting Cancer Risk in SCD
The distinction between a possible increase in relative risk and a person’s absolute chance of cancer matters for patients and clinicians. The review cited in the report says absolute malignancy risk in SCD is low, even as it calls attention to blood cancers in particular. Mixed findings do not support treating every person with SCD as having a confirmed cancer-predisposition syndrome.
The question also matters because cancer concerns have accompanied some SCD treatments. Clinical trials of the gene therapy lovotibeglogene autotemcel (lovo-cel) were paused after one participant developed leukemia and another developed myelodysplastic syndrome. The manufacturer said an investigation found the therapy was “very unlikely” to have caused the cases; the FDA later lifted the hold. The report notes that lovo-cel labeling carries a boxed warning about potential malignancy risk. These events warrant careful attention, but they do not resolve baseline cancer risk across people with SCD.
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Studies and Treatment Concerns
Early reports of cancer in SCD largely relied on case reports and survey-based research, which can identify signals but cannot reliably establish how common a condition is or whether one factor caused another. Later population-based studies were larger, yet their conclusions differed. Differences in study methods, participant groups, cancer categories and follow-up can affect estimates.
Gene therapy trials renewed public and clinical attention after the reported leukemia and myelodysplastic syndrome cases. The FDA subsequently approved lovo-cel and exagamglogene autotemcel (exa-cel) as SCD gene therapies. The report also notes historical concerns about hydroxyurea and cancer; Sana Saif Ur Rehman, a Washington University physician who treats adults with SCD, said she considers those concerns to have been refuted. She cautioned that high-dose chemotherapy used in gene therapy and stem cell transplantation can raise concerns in particular treatment circumstances. These treatment-related questions are separate from whether SCD itself raises cancer risk.
“I would say there appears to be an increased malignancy risk in sickle cell disease. I think the extent to which there is an increased malignancy risk remains not so well established.”
— Vijay Sankaran, MD, PhD, of Harvard Medical School and Boston Children’s Hospital
What the Evidence Cannot Establish
Researchers have not settled whether SCD independently increases cancer risk, how large any increase might be, or which patients would face it. The studies report different outcomes, and the available material does not provide enough detail to compare their follow-up periods or adjust for all possible differences between participants. Clonal hematopoiesis findings may help explain blood-cell changes, but they do not establish a cancer diagnosis or a causal pathway.
The report also leaves open how treatment exposures affect individual risk. High-dose chemotherapy in gene therapy or stem cell transplantation is a different question from baseline risk associated with SCD. The precise causes of the trial participants’ cancers and the longer-term cancer outcomes across treated populations are not resolved by the information provided. No particular screening change is established in the report.
Further Studies Will Refine Estimates
More population research and sensitive laboratory testing will be needed to clarify whether clonal hematopoiesis is more common in SCD, how it changes with age, and whether it predicts later malignancy. Studies that track participants over time and distinguish cancer types and treatment histories could help explain why earlier estimates diverged. The report does not identify a specific forthcoming study or publication date.
For now, the evidence supports vigilance without overstating certainty: cancer is described as a rare event in SCD, and the overall risk remains disputed. Clinicians and patients will need to interpret any concerns alongside the person’s treatment history and current medical circumstances.
Key Questions
Does sickle cell disease increase cancer risk?
It remains uncertain. Some studies report higher overall or blood-cancer risk, while others find no overall increase. Researchers have not established a definitive causal link.
Which cancers have been linked to sickle cell disease in studies?
Several studies have focused on blood cancers, including leukemia and myeloid leukemia. Findings for solid cancers vary, with one California study reporting lower solid-cancer risk. The results differ across studies.
Does sickle cell trait carry the same reported risk as sickle cell disease?
No. Sickle cell trait is distinct from SCD. A study described in the report found no significant overall association between the trait and cancer, though it noted a trend toward higher kidney-cancer risk and lower leukemia risk compared with SCD.
Has gene therapy been proven to cause cancer in people with SCD?
The report does not establish that. Trials of lovo-cel were paused after two participants developed blood-related malignancies, and the manufacturer said its investigation found the therapy was “very unlikely” to be the cause. Lovo-cel labeling includes a boxed warning about potential malignancy risk.
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