Risk relationship between six autoimmune diseases and malignancies: An umbrella review.

in Autoimmunity reviews by Ping Yang, Qinguo Liu, Hengheng Zhang, Meijie Wu, Jiuda Zhao, Guoshuang Shen, Yi Zhao

TLDR

  • The study found that five autoimmune diseases are positively associated with the risk of overall malignancy, with varying risk relationships between diseases and specific cancers.
  • The findings underscore the importance of individualized management of patients with autoimmune diseases, including cancer risk assessment and prevention.

Abstract

The bidirectional relationship between autoimmune diseases and malignancy has been widely discussed. And the relationship between autoimmune diseases and the risk of malignancy varies. Here, we categorized and re-analyzed the evidence of the association between six autoimmune diseases and malignancy risk, in order to provide ideas for the prevention of malignancy in the long-term individualized management of patients with autoimmune diseases. We systematically searched the relevant literatures in PubMed, Web of Science and Cochrane Library to identify and re-analyze studies methodically on the association between six autoimmune diseases and their malignancy risk. Our results showed that. We included 34 meta-analyses including systematic lupus erythematosus, rheumatoid arthritis, psoriasis, ankylosing spondylitis, primary Sjogren's syndrome, multiple sclerosis, totalling 742 studies. Our results showed that the remaining five AIDs, with the exception of MS, were positively associated with the risk of overall malignancy. Among them, patients with SLE had the highest risk of developing lymphomas, oropharyngeal cancer and non-Hodgkin's lymphoma, and the lowest risk of developing uterine cancer, melanoma and endometrial cancer. The RA patients had the highest risk of developing lymphomas, Hodgkin's lymphoma and non-Hodgkin's and the lowest risk of colon cancer. pSS patients had the highest risk of lymphoma. MS patients had the highest risk of lung cancer and the lowest risk of testicular cancer. AS patients had the highest risk of lymphoblastic leukemia. PsO patients had the highest risk of keratinocyte cancer. Patients with systematic lupus erythematosus, rheumatoid arthritis, psoriasis, ankylosing spondylitis and primary Sjogren's syndrome lead to an increased risk of overall malignancy, whereas patients with MS lead to a decreased risk of overall malignancy. However, the risk relationship between the same AIDs and different malignancies varied.

Overview

  • The study analyzed the relationship between six autoimmune diseases (AIDs) and the risk of malignancy, with the aim of providing ideas for long-term individualized management of patients with AIDs.
  • The study included 34 meta-analyses of studies on the association between the six AIDs (systemic lupus erythematosus, rheumatoid arthritis, psoriasis, ankylosing spondylitis, primary Sjogren's syndrome, and multiple sclerosis) and their malignancy risk.
  • The primary objective of the study was to categorize and re-analyze the evidence on the association between specific AIDs and the risk of malignancy, in order to provide guidance for patient management.

Comparative Analysis & Findings

  • The results showed that five AIDs (except multiple sclerosis) were positively associated with the risk of overall malignancy, with systemic lupus erythematosus having the highest risk of developing certain types of cancer.
  • The study found that patients with rheumatoid arthritis had a higher risk of developing lymphomas, Hodgkin's lymphoma, and non-Hodgkin's lymphoma, but a lower risk of colon cancer.
  • The risk relationship between the same AIDs and different malignancies varied, with patients with multiple sclerosis having a decreased risk of overall malignancy, for example.

Implications and Future Directions

  • The study provides valuable insights for the long-term management of patients with AIDs, highlighting the need for individualized approaches to cancer risk assessment and prevention.
  • Future research should investigate the underlying mechanisms driving the association between AIDs and malignancy risk, and explore novel therapies targeting these mechanisms.
  • The study's findings also underscore the importance of close monitoring for cancer development in patients with AIDs, particularly in those with high-risk profiles.
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