Autoimmune diseases increase cancer risk

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Link between autoimmune diseases and cancer discovered

Various autoimmune diseases appear to be directly related to the occurrence of cancer. This is the conclusion reached by the epidemiologist Kari Hemminki from the German Cancer Research Center (DKFZ) together with Swedish colleagues when examining the "relationship between 33 different autoimmune diseases and eleven different cancers of the entire digestive tract."

The scientists of the German Cancer Research Center have investigated possible connections between autoimmune diseases and the occurrence of cancer in the oral cavity, esophagus, gastrointestinal tract, liver and pancreas in a comprehensive study. The DKFZ experts found that most autoimmune diseases are associated with a significantly increased risk of cancer, whereas in some autoimmune diseases the cancer risk is sometimes even reduced.

Together with their Swedish colleagues, the DKFZ researchers evaluated the data from the Swedish cancer registry, which recorded a total of twelve million people. The scientists around Kari Hemminki focused on the data of people who had to be hospitalized for an autoimmune disease since 1964 and who later developed cancer (until 2008). Due to the large amount of data available, the researchers were able to take into account rare autoimmune diseases in their investigation and analyze a possible connection with the risk of cancer, the experts report in the current edition of the specialist magazine "Annals of Oncology".

Four times higher cancer risk for certain autoimmune diseases The researchers' calculations show that, for example, a special form of anemia (pernicious anemia) shows a four times higher risk of gastric cancer compared to the average population. The autoimmune disease myasthenia gravis, which occurs as a disorder in neuromuscular transmission of excitation, causes an increased risk of disease even in five different types of cancer, according to the DKFZ scientists. According to this, the risk of esophageal cancer among those affected is around three times as high as the average of the population, the risk of stomach and colon cancer is around 30 percent higher. Other autoimmune diseases that are associated with an increased risk of developing several types of cancer in the digestive tract are Crohn's disease (inflammatory bowel disease), the so-called systemic lupus (autoimmune disease of the connective tissue), ulcerative colitis (chronic inflammatory bowel disease of the rectum and colon) and Psoriasis (chronic inflammatory skin disease). Autoimmune diseases in which the risk of cancer is noticeably reduced include rheumatism. For example, rheumatism sufferers are 30 percent less likely to have colorectal cancer, the DKFZ epidemiologists report.

Medication of autoimmune diseases as the cause of changed cancer risk? The DKFZ scientists cited the effects of the different drugs administered as a possible cause for the connection between the occurrence of cancer and diseases in which the immune system fights the body's own structures. For example, many of the autoimmune diseases would be treated with drugs that are supposed to prevent an excessive reaction of the immune system and, for this purpose, reduce the body's defense mechanisms. The DKFZ experts suspect that the organism is also less able to fight the tumor cells and the risk of cancer increases. The researchers attribute the fact that the risk of cancer to rheumatism was reduced by taking anti-inflammatory drugs. For example, the aspirin active ingredient ASA, which is found in many rheumatism medications, has a cancer-preventing effect, report Kari Hemminki and colleagues. However, the most important result of their investigations, the researchers assessed, was the proven increased risk of cancer in certain autoimmune diseases. Because in the future, preventive examinations could be specially adapted to this group of patients and "Doctors recommend their patients with autoimmune diseases to regularly participate in cancer screening programs", emphasized the DKFZ scientists. (fp)

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