JAMA Sub-Journal: Patients with these diseases, beware of cancer!

When listening to various academic reports and expert lectures, Singularity Cake always hears such a sentence, "In recent years, due to changes in life>
.
"
And this "XX disease" is often a variety of vicious cancers, or some indirect but indirect disease that is mediated by the immune system and is very difficult to cure, such as inflammatory bowel disease (IBD), Asthma, rheumatoid arthritis, and even some unpopular diseases whose names are hard to remember.
.
.
But Singularity Cake has always been curious about one question: the relationship between cancer and the immune system is endless to write N books, immune-mediated diseases look at the name You know who is behind the scenes.
What is the relationship between these two diseases? Is autoimmune disease and cancer a seesaw relationship? (Image source: Drug Discovery World) The Harvard University team recently published a study on JAMA Oncology, which confuses the singularity, but the research data is also surprising enough: 470,000 participants from the UK Biobank The data of the authors show that suffering from any kind of "immune-mediated disease" is related to an 8% increase in the risk of cancer
.

Some of these specific immune-mediated diseases are even related to the risk of cancer in the affected parts and organs increasing by more than 40 times! Moreover, the risk of cancer in the organs around the affected part and even the whole body will be increased [1]
.

It seems that there is something wrong with the immune system, and the impact is really profound
.

Judging from the existing basic scientific research evidence, cancer and immune-mediated diseases do indeed “share” some abnormal immune pathways, such as the IL-12/IL-23 inflammatory pathway, which is an important therapeutic target for psoriasis and IBD, as well.
It can affect the tumor microenvironment and participate in the occurrence and development of cancer [2]
.

Inflammatory bowel disease is associated with an increased risk of colorectal cancer, and primary sclerosing cholangitis (PSC) is associated with an increased risk of intrahepatic cholangiocarcinoma.
This has also been confirmed by a large number of studies
.

But will the "local effects" of these immune-mediated diseases be amplified throughout the body? According to the Harvard team’s statement in the paper, there is indeed no relevant research before, because various influencing factors must be included in the analysis, such as life>
.

Another major advantage of the British Biobank is the genetic sequencing.
After all, the immune system is too complicated.
A total of 478,000 participants were included in this analysis.
During the 10-year follow-up period, 61,500 (13%) were affected.
At least one immune-mediated disease has been diagnosed
.
Among the participants, 2834 cases of cancer have since been diagnosed .
Among the participants without immune-mediated disease, 26817 cases of cancer have been diagnosed .

Calculating the risk based on this data, then suffering from at least one immune-mediated disease is related to a relative increase of 8% (HR=1.
08, 95% CI: 1.
04-1.
12) of the participant’s risk of being diagnosed with any type of cancer, and the impact does not seem to be significant
.

Even if it is refined to a single disease, only ulcerative colitis, asthma and PSC are associated with an increased risk of systemic cancer
.

But if you continue to subdivide, the situation is different
.

First of all, according to the location of the diagnosis of cancer in patients with immune-mediated diseases, as long as they have at least one disease, it is related to a relative increase in the risk of lung cancer by 36%, a relative increase in the risk of lymphoma by 49%, and a relative increase in the risk of liver cancer by 75%.
These are not small numbers
.

Correlation between cancers in different parts and immune-mediated diseases.
According to the cancers that occur "in situ" in immune-mediated diseases, celiac disease is associated with nearly 7 times the risk of small bowel cancer (HR=6.
89), autoimmune hepatitis It is associated with a 20-fold increase in the risk of hepatobiliary cancer (HR=21.
26).
PSC is more closely related to the risk of hepatobiliary cancer.
The risk is increased by 42 times (HR=42.
12).
.
.
There are also 13 immune-mediated diseases, which will It is related to the risk of cancers in nearby organs, distant organs and even completely different systems.
For example, ulcerative colitis and Crohn’s disease are related to the increased risk of nearby liver cancer (HR=4.
01/2.
59), but ulcerative colitis It is also associated with an increased risk of prostate cancer in the urinary system
.

The research team pointed out in the paper that some of these phenomena can be explained by known mechanisms.
For example, inflammatory bowel disease affects the gut-liver axis and intestinal flora, thereby participating in the occurrence of gastrointestinal cancer; "For example, psoriasis is related to the increased risk of lung cancer and esophageal cancer.
It is worthy of further exploration
.

All in all, those who unfortunately suffer from immune-mediated diseases should not only focus on fighting these difficult diseases, but should pay attention to their health and be alert to these additional cancer risks
.

For scientists, the relationship between immune or inflammatory response and specific cancers can be clarified as soon as possible to achieve precise intervention in the future
.

References: 1.
He M, Lo CH, Wang K, et al.
Immune-Mediated Diseases Associated With Cancer Risks[J].
JAMA Oncology, 2021.
2.
Chyuan IT, Lai J H.
New insights into the IL-12 and IL -23: From a molecular basis to clinical application in immune-mediated inflammation and cancers[J].
Biochemical Pharmacology, 2020, 175: 113928.
The author of this articleTan Shuo