In a study reported in JAMA Oncology, He et al found that individuals with immune-mediated diseases were at an increased risk of developing cancer, with organ-specific immune-mediated diseases being more strongly associated with local vs extralocal cancers.
Study Details
The prospective cohort study used data from the UK Biobank cohort study of adults aged 37 to 73 years recruited at 22 centers in the United Kingdom between January 2006 and December 2010, with follow-up through February 2019. The association of 48 immune-mediated diseases with risk of total and individual cancers was assessed.
Key Findings
A total of 478,753 participants were included in the study. During 4,600,460 person-years of follow-up, a total of 2,834 cases of cancer were documented in 61,496 patients with immune-mediated diseases vs 26,817 cases in 417,257 patients with no immune-mediated diseases, yielding a hazard ratio (HR) on multivariate analysis of 1.08 (95% confidence interval [CI] = 1.04–1.12, P < .001).
... Immune-mediated diseases were associated with an increased risk of total cancer. Organ-specific immune-mediated diseases had stronger associations with risk of local cancers than extralocal cancers. The associations for individual immune-mediated diseases were largely organ-specific but were also observed for some cancers in the near and distant organs or different systems. Our findings support the role of local and systemic immunoregulation in cancer development.— He et al
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Five organ-specific immune-mediated diseases were significantly associated with higher risk of local but not extralocal cancers, including asthma (HR = 1.34, 95% CI = 1.14–1.56), celiac disease (HR = 6.89, 95% CI = 2.18–21.75), idiopathic thrombocytopenic purpura (associated with hematologic cancers; 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). In contrast, ulcerative colitis was significantly associated with a higher risk of both colorectal cancer and extra-colorectal cancer, with the association being stronger for colorectal (HR = 1.73, 95% CI = 1.26–2.39) vs extra-colorectal cancer (HR = 1.30, 95% CI = 1.13–1.49).
Nine immune-mediated diseases were associated with increased risk of cancers in the involved organs, including asthma with lung cancer (HR = 1.34, 95% CI = 1.14–1.57) and celiac disease with small intestine cancer (HR = 6.89, 95% CI = 2.18–21.75).
Thirteen immune-mediated diseases were associated with increased risk of cancer in near organs, including Crohn's disease with liver cancer (HR = 4.01, 95% CI = 1.65–9.72); distant organs, including autoimmune hepatitis with tongue cancer (HR = 27.75, 95% CI = 3.82–199.91); or different systems, including idiopathic thrombocytopenic purpura with liver cancer (HR = 11.96, 95% CI = 3.82–37.42).
The investigators concluded, “In this cohort study, immune-mediated diseases were associated with an increased risk of total cancer. Organ-specific immune-mediated diseases had stronger associations with risk of local cancers than extralocal cancers. The associations for individual immune-mediated diseases were largely organ-specific but were also observed for some cancers in the near and distant organs or different systems. Our findings support the role of local and systemic immunoregulation in cancer development.”
Mingyang Song, MD, ScD, of the Department of Epidemiology, Harvard T.H. Chan School of Public Health, is the corresponding author for the JAMA Oncology article.
Disclosure: The study was supported by grants from the American Cancer Society, National Institutes of Health, and German Research Foundation, and others. For full disclosures of the study authors, visit jamanetwork.com.
