Immune-mediated diseases and risk of cancer

January 2022 Science Nalinee Pathak

According to results published in JAMA Oncology, immune-mediated diseases (asthma, autoimmune hepatitis, celiac disease etc.) may increase the risk of cancer. Researchers have comprehensively assessed the association of 48 immune-mediated diseases with cancer risk. In addition, they have studied the association of organ-specific immune diseases with local and extra-local cancers.

Study details

A prospective cohort study analysed patient data from the UK Biobank for total and individual cancer risk associated with 48 immune-mediated diseases. Between 1 January 2006, and 31 December 2010 478,753 (age range, 37-73 years, 54% female) participants were recruited in the UK biobank at 22 assessment centres across the UK.

Key findings

In the data gathered over 4 million person-years of follow-up, 2,834 cases of cancers were observed in 61,496 patients with immune-mediated diseases compared to 26,817 cancers in 417,257 patients without immune-mediated diseases (multivariable HR: 1.08; 95% CI: 1.04-1.12). It was found that five organ-specific immune-mediated diseases were significantly associated with a high risk of local (not extra-local) cancers. These included asthma (HR: 1.34; 95% CI: 1.14-1.56), celiac disease (HR: 6.89; 95% CI, 2.18-21.75), idiopathic thrombocytopenic purpura (HR: 6.94; 95% CI: 3.94-12.25), primary biliary cholangitis (HR: 42.12; 95% CI: 20.76-85.44) and autoimmune hepatitis (HR: 21.26; 95% CI: 6.79-66.61) (P<0.002 for heterogeneity).

Nine immune-mediated diseases were associated with an increased risk of organ-specific immune disease. These associations include asthma with lung cancer (HR: 1.34; 95% CI: 1.14-1.57; P<0.001) and celiac disease with small intestine cancer (HR: 6.89; 95% CI: 2.18-21.75; P=0.001). In addition, thirteen immune-mediated diseases were associated with an increased risk of cancer in nearby organs, distant organs, or different systems. This included Crohn’s disease with liver cancer (HR, 4.01; 95% CI, 1.65-9.72; P =.002), autoimmune hepatitis with tongue cancer (HR = 27.75, 95% CI = 3.82–199.91, p=0.001), and idiopathic thrombocytopenic purpura with liver cancer (HR: 11.96; 95% CI: 3.82-37.42; P<0.001).

Conclusion

The findings of this posthoc analysis demonstrate a significant association of immune-mediated diseases with an increased risk of cancer. The results show the role of local and systemic immunoregulation in cancer development.

Reference

He MM, Lo CH, Wang K, Polychronidis G, et al. Immune-Mediated Diseases Associated With Cancer Risks. JAMA Oncol. 2021 Dec 2:e215680. doi: 10.1001/jamaoncol.2021.5680. Epub ahead of print. PMID: 34854871; PMCID: PMC8640951.

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