Higher Cancer Risk for People with Immune-Mediated Diseases

Celiac.com 02/28/2022 - Immune regulation is important for carcinogenesis; however, the cancer risk profiles associated with immune-mediated diseases, like celiac disease, are not well understood.

A team of researchers recently set out to assess the profiles of cancer risk associated with 48 immune-mediated diseases with the risk of total and individual cancers. They also assessed the prospective association of organ-specific immune-mediated diseases with the risk of local and extra-local cancers.

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The research team included Ming-ming He, MD; Chun-Han Lo, MD, MPH; Kai Wang, MD, PhD; Georgios Polychronidis, MD; Liang Wang, MD; Rong Zhong, PhD; Markus D. Knudsen, PhD; Zhe Fang, MD; and Mingyang Song, MD, ScD.

For their prospective cohort study, the team used data from the UK Biobank cohort study on adults aged 37 to 73 years who were recruited at twenty-two assessment centers throughout the UK between January 1, 2006, and December 31, 2010, with follow-up through February 28, 2019.

After adjusting for various potential confounders using time-varying Cox proportional hazards regression, the team assessed the connection between immune-mediated diseases with risk of cancer with multivariable hazard ratios (HRs) and 95% CIs. They used the contrast test method to assess heterogeneity in the associations of organ-specific immune-mediated diseases with local and extra-local cancers.

In this group study of nearly half a million participants, the team found that immune-mediated diseases were associated with an increased total cancer risk. 

Organ-specific immune-mediated diseases showed higher associated risk of local cancers than extra-local cancers, and many immune-mediated diseases were associated with increased risk for cancer in the near and distant organs or other systems. 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 seen for some cancers in the near and distant organs or different systems. 

Their findings suggest that immune-mediated diseases are associated with risk of cancer at the local and systemic levels, which supports the role of local and systemic immunoregulation in the development of cancers.

Read more in JAMA Oncology

The researchers are variously affiliated with the Department of Medical Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China; the Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; the Clinical and Translational Epidemiology Unit, Massachusetts General Hospital, Harvard Medical School, Boston; the Division of Gastroenterology, Massachusetts General Hospital, Harvard Medical School, Boston; the Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Heidelberg, Germany; the Study Centre of the German Surgical Society, University of Heidelberg, Heidelberg, Germany; the Center of Gastrointestinal Surgery, First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China; the Section for Colorectal Cancer Screening, Cancer Registry of Norway, Oslo, Norway; the Division of Surgery, Department of Transplantation Medicine, Inflammatory Diseases and Transplantation, Norwegian PSC Research Center, Oslo University Hospital, Oslo, Norway; and the Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.