The post hoc analysis of a UK prospective cohort study suggested that immune-mediated diseases were associated with risk of cancer at the local and systemic levels. The analysis included 478 753 participants (mean age, 56.4 years; 54% female) between 2006 and 2010, with follow-up through 2019. During 4 600 460 person-years of follow-up, a total of 2834 cases of cancer were identified in 61 496 patients with immune-mediated diseases and 26 817 cases of cancer in 417 257 patients without any immune-mediated diseases (multivariable HR, 1.08). Five of the organ-specific immune-mediated diseases were significantly associated with higher risk of local but not extralocal cancers: asthma (HR, 1.34), celiac disease (HR, 6.89), idiopathic thrombocytopenic purpura (HR, 6.94), primary biliary cholangitis (HR, 42.12), and autoimmune hepatitis (HR, 21.26). Nine immune-mediated diseases were associated with an increased risk of cancers in the involved organs (eg, asthma with lung cancer [HR, 1.34] and celiac disease with small intestine cancer [HR, 6.89]); 13 immune-mediated diseases were associated with an increased risk of cancer in the near organs (eg, Crohn disease with liver cancer: [HR, 4.01]) or distant organs (eg, autoimmune hepatitis with tongue cancer [HR, 27.75]) or in different systems (eg, idiopathic thrombocytopenic purpura with liver cancer [HR, 11.96]). The findings are consistent with prior studies, support the importance of local and systemic immunoregulation in carcinogenesis, and imply that increased surveillance may be warranted for the immune-mediated diseases with high cancer risk. Source: https://jamanetwork.com/
