Cancer Incidence in Multiple Sclerosis: A 35-Year Follow-Up

Sumelahti, Marja‐Liisa; Pukkala, Eero; Hakama, Matti

doi:10.1159/000079947

Cited by 44 publications

(49 citation statements)

References 22 publications

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“…An alternative explanation for the overall null result is a possible underrepresentation of RA patients with severe disease and presumably higher risk of lymphoma 38 through selfselection in case-control studies as opposed to in registry-based cohort studies. 10 Inflammatory bowel disorders, type 1 diabetes, sarcoidosis, pernicious anemia, and multiple sclerosis were not associated with risk of NHL overall, consistent with the majority of previous reports, 14,30,[40][41][42] and there was no strong evidence for subtypespecific associations. In Crohn's disease, a recent large metaanalysis 43 reported a moderately increased risk of lymphoma overall, but latency was not evaluated; therefore a possible risk inflation by initial misdiagnoses of lymphomas cannot be excluded.…”

Section: Autoimmune Disorders and Lymphoma Subtypes 4035supporting

confidence: 83%

Autoimmune disorders and risk of non-Hodgkin lymphoma subtypes: a pooled analysis within the InterLymph Consortium

Smedby

Vajdic

Falster

et al. 2008

Blood

508

223

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Some autoimmune disorders are increasingly recognized as risk factors for nonHodgkin lymphoma (NHL) overall, but large-scale systematic assessments of risk of NHL subtypes are lacking. We performed a pooled analysis of selfreported autoimmune conditions and risk of NHL and subtypes, including 29 423 participants in 12 case-control studies. We computed pooled odds ratios (OR) and 95% confidence intervals (

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Section: Autoimmune Disorders and Lymphoma Subtypes 4035supporting

confidence: 83%

Autoimmune disorders and risk of non-Hodgkin lymphoma subtypes: a pooled analysis within the InterLymph Consortium

Smedby

Vajdic

Falster

et al. 2008

Blood

508

223

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“…Exclusion of irrelevant references and/or duplicates left 204 potential full-text articles. Fifty-one articles [3,7,23,24,25,26,27,28,29,30,31,32,33,34,35,36,37,38,39,40,41,42,43,44,45,46,47,48,49,50,51,52,53,54,55,56,57,58,59,60,61,62,63,64,65,66,67,68,69,70,71] (with a total of 577,013 participants) fulfilled our inclusion criteria (fig. 1) and were included in the qualitative data synthesis.…”

Section: Resultsmentioning

confidence: 99%

“…Eight studies [32,36,37,38,39,40,41,42] on 54,929 patients with MS reflected a reduced incidence of cancer in general (ES = 0.91; 95% CI: 0.87-0.95; I 2 = 30.3%), with low between-study heterogeneity (Q statistic: p = 0.19; fig. 2).…”

Section: Resultsmentioning

confidence: 99%

Inverse and Direct Cancer Comorbidity in People with Central Nervous System Disorders: A Meta-Analysis of Cancer Incidence in 577,013 Participants of 50 Observational Studies

Catalá-López¹,

Suárez-Pinilla²,

Suárez-Pinilla³

et al. 2014

Psychother Psychosom

170

141

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Background: There is a lack of scientific consensus about cancer comorbidity in people with central nervous system (CNS) disorders. This study assesses the co-occurrence of cancers in patients with CNS disorders, including Alzheimer's disease (AD), amyotrophic lateral sclerosis (ALS), autism spectrum disorders, Down's syndrome (DS), Huntington's disease (HD), multiple sclerosis (MS), Parkinson's disease (PD) and schizophrenia (SCZ). Method: Comprehensive search in PubMed/MEDLINE, Scopus and ISI Web of Knowledge of the literature published before March 2013. We identified 51 relevant articles from 2,229 discrete references, 50 of which contained data suitable for quantitative synthesis (577,013 participants). Pooled effect sizes (ES) were calculated using multiple random-effects meta-analyses. Sources of heterogeneity and uncertainty were explored by means of subgroup and sensitivity analyses, respectively. Results: The presence of CNS disorders was associated with a reduced co-occurrence of cancer (ES = 0.92; 95% confidence interval, CI: 0.87-0.98; I² = 94.5%). A consistently lower overall co-occurrence of cancer was detected in patients with neurodegenerative disorders (ES = 0.80; 95% CI: 0.75- 0.86; I² = 82.8%), and in those with AD (ES = 0.32; 95% CI: 0.22-0.46; I² = 0.0%), PD (ES = 0.83; 95% CI: 0.76-0.91; I² = 80.0%), MS (ES = 0.91; 95% CI: 0.87-0.95; I² = 30.3%) and HD (ES = 0.53; 95% CI: 0.42-0.67; I² = 56.4%). Patients with DS had a higher overall co-occurrence of cancer (ES = 1.46; 95% CI: 1.08-1.96; I² = 87.9%). No association was observed between cancer and ALS (ES = 0.97; 95% CI: 0.76-1.25; I² = 0.0%) or SCZ (ES = 0.98; 95% CI: 0.90-1.07; I² = 96.3%). Patients with PD, MS and SCZ showed (a) higher co-occurrence of some specific cancers (e.g. PD with melanoma, MS with brain cancers and SCZ with breast cancer), and (b) lower co-occurrence of other specific cancers (e.g. lung, prostate and colorectal cancers in PD; lung and prostate cancers in MS; and melanoma and prostate cancer in SCZ). Conclusion: Increased and decreased co-occurrence of cancer in patients with CNS disorders represents an opportunity to discover biological and non-biological connections between these complex disorders.

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“…However, there was no significantly increased risk beyond the first year of follow-up; thus, the positive association could be due to misclassification. In multiple sclerosis, studies have consistently shown no excess risk of lymphoma or hematopoietic malignancy (113)(114)(115). Associations between diabetes mellitus and malignant lymphomas have been described occasionally (116), but the overall picture is that of no association (117,118).…”

Section: Autoimmune/inflammatory Conditions Linked To Lymphomamentioning

confidence: 99%

Malignant Lymphomas in Autoimmunity and Inflammation: A Review of Risks, Risk Factors, and Lymphoma Characteristics

Smedby

Baecklund

Askling

2006

Cancer Epidemiology, Biomarkers &Amp; Prevention

218

146

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Certain autoimmune and chronic inflammatory conditions, such as Sjögren's syndrome and rheumatoid arthritis (RA), have consistently been associated with an increased risk of malignant lymphomas, but it is unclear whether elevated lymphoma risk is a phenomenon that accompanies inflammatory conditions in general. Likewise, it is debated whether the increased risk identified in association with some disorders pertains equally to all individuals or whether it varies among groups of patients with different phenotypic or treatment-related characteristics. It is similarly unclear to what extent the increased lymphoma occurrence is mediated through specific lymphoma subtypes. This update reviews the many findings on risks, risk levels, and lymphoma characteristics that have been presented recently in relation to a broad range of chronic inflammatory, including autoimmune, conditions. Recent results clearly indicate an association between severity of chronic inflammation and lymphoma risk in RA and Sjögren's syndrome. Thus, the average risk of lymphoma in RA may be composed of a markedly increased risk in those with most severe disease and little or no increase in those with mild or moderate disease. The roles of immunosuppressive therapy and EBV infection seem to be limited. Furthermore, RA, Sjögren's syndrome, systemic lupus erythematosus, and possibly celiac disease may share an association with risk of diffuse large B-cell lymphoma, in addition to well-established links of Sjögren's syndrome with risk of mucosa-associated lymphoid tissue lymphoma and of celiac disease with risk of small intestinal lymphoma. However, there is also obvious heterogeneity in risk and risk mediators among different inflammatory diseases. (Cancer Epidemiol Biomarkers Prev 2006;15(11):2069–77)

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Cancer Incidence in Multiple Sclerosis: A 35-Year Follow-Up

Cited by 44 publications

References 22 publications

Autoimmune disorders and risk of non-Hodgkin lymphoma subtypes: a pooled analysis within the InterLymph Consortium

Autoimmune disorders and risk of non-Hodgkin lymphoma subtypes: a pooled analysis within the InterLymph Consortium

Inverse and Direct Cancer Comorbidity in People with Central Nervous System Disorders: A Meta-Analysis of Cancer Incidence in 577,013 Participants of 50 Observational Studies

Malignant Lymphomas in Autoimmunity and Inflammation: A Review of Risks, Risk Factors, and Lymphoma Characteristics

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