In Sjögren’s, cancer risk is real. >9yr multicenter cohort (n=314), overall cancer risk ↑ (SIR 1.68), NHL >15× expected Predictors: older age, smoking, LAD, splenomegaly, cryoglobulinemia (strongest for lymphoma). Malignancies = 24% of deaths @RheumNow #ACR25 Abstract #1681