Association Found Between Immune-Mediated Diseases and Increased Cancer Risk

Immune-mediated diseases were associated with an increased risk of total cancer, and a stronger association was observed with organ-specific immune-mediated diseases and risk of local cancer vs extra-local cancers, according to research from a cohort study published in JAMA Oncology.

In 61,496 patients with immune-mediated diseases, 26,834 cancer cases among 61,496 patients were observed. Moreover, investigators reported 26,817 cancer cases in 417,257 patients without immune-mediated diseases (multivariable HR, 1.08; 95% CI, 1.04-1.12). The organ-specific immune-mediated diseases that were significantly associated with an increased risk of local cancers 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 <.002); notably, they were not associated with extra-local cancers.

“Many immune-mediated diseases were associated with increased risk of cancers in the involved organs and in the near and distant organs or different systems,” the investigators wrote.

This post hoc analysis was part of the United Kingdom Biobank study, which recruited 502,536 adults aged 37 to 73 years between January 1, 2006, and December 31, 2010. Patients with prevalent cancer at the time of recruitment (n = 23,753) and those who withdrew consent (n = 30) were removed from the study population.

Forty-eight immune-mediated diseases were identified, and investigators compared cancer risk between individuals with and without these diseases. The incidence of total and individual cancers was the main outcome of interest.

Of the 478,753 patients who were included in the study population,thr mean age was 56.4 years. Most patients were White (95%) and female (54%), and 13% of patients had at least 1 immune-mediated disease.

For individual cancers, those with immune- mediated disease were at increased risk of lung cancer (multivariable-adjusted HR, 1.36; 95% CI, 1.20-1.53), lymphoma (multivariable-adjusted HR, 1.49; 95% CI, 1.26-1.75), and liver cancer (HR, 1.75; 95% CI, 1.30-2.36).

Other findings from the study highlighted 2 associations of cancer in the involved organs for diseases such as sicca syndrome of the small intestine (HR, 8.49; 95% CI, 1.18-61.32) and mouth cancers (13.59; 95% CI, 1.86-99.09), as well as Guillain- Barré syndrome in those with soft tissue cancer (HR, 11.17; 95% CI, 1.56-79.80).

A total of 13 immune-mediated diseases that were associated with a higher risk of cancer in the near or distant organs or different systems and 12 immune-mediated diseases associated with cancers in different systems.

“These findings support the importance of local and systemic immunoregulation in carcinogenesis and may inform future research elucidating the role of immunoregulation and microbiota in cancer development,” the investigators concluded.

Reference

He MM, Lo CH, Wang K, et al. Immune-mediated diseases associated with cancer risks. JAMA Oncol. Published online December 2, 2021. doi:10.1001/jamaoncol.2021.5680