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.
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.
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).
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.
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