Association between autoimmune rheumatic diseases and head and neck cancer: Systematic review and meta‐analysis

Abstract

Background: Personal history of autoimmune rheumatic diseases has been implicated in the development of malignant neoplasms. Our aim was to assess the risk of head and neck (H&N) cancers in patients with autoimmune rheumatic diseases. Methods:The articles search included PubMed, EMBASE, LILACS, The Cochrane Library, CINAHL, Scopus, Web of Science, and Google Scholar with no language restrictions for studies published from inception of the databases to August 20, 2022, assessing the risk of H&N cancer in patients with autoimmune rheumatic diseases. Studies were included if they reported the standardized incidence ratio (SIR) with corresponding 95% confidence intervals (CIs). The primary outcome was risk of H&N cancers in patients with autoimmune rheumatic diseases compared with the general population. Pooled summary estimates were calculated using a random-effects model, and subgroup analyses were done to establish whether risk of H&N cancers varied according to study site.Results: Our search identified 5378 records, of which 32 cohort studies were eligible for systematic review and 24 for meta-analysis (including 273 613 patients). A significant association was found between H&N cancer and autoimmune rheumatic diseases (SIR = 2.35; 95% CI: 1.57-3.50; p < 0.01, I 2 = 94%). Conclusion:Our study suggests that patients with autoimmune rheumatic diseases had a significantly increased risk of H&N cancer compared with the general population, including thyroid, oral, and nasopharyngeal cancers. These findings have implications for the individualized screening of these patients and the planning of oncology units. The protocol is registered with PROSPERO, number CRD42020197827.

Exploring the Link between Head and Neck Cancer and Elevated Risk of Rheumatoid Arthritis: A National Population-Based Cohort Study

“…Thus, large-scale studies could provide an excellent opportunity to gain insight into the intricate relationship between autoimmune conditions and cancer development. Notably, a recent systematic review and meta-analysis revealed a 2.35-fold increase in the overall incidence of HNC among individuals with autoimmune rheumatic diseases, surpassing the rates observed in the general population [ 13 ]. Moreover, the present study identified a significant 1.49-fold increase in the overall incidence of RA events among patients with HNC compared to controls.…”

“…Thus, HNC has exhibited associations with various autoimmune rheumatic diseases [ 10 , 11 , 12 ]. Moreover, one recent study showed that individuals with autoimmune rheumatic diseases, inclusive of conditions affecting the thyroid, oral cavity, and nasopharynx, exhibited a conspicuously heightened risk of developing HNC in comparison to the general populace [ 13 ]. One investigation conducted within the European population revealed an augmented susceptibility to HNC among individuals diagnosed with RA [ 14 ].…”

Immune Checkpoint Inhibitors, Small-Molecule Immunotherapies and the Emerging Role of Neutrophil Extracellular Traps in Therapeutic Strategies for Head and Neck Cancer

“…The role of the immune system in tumor regulation is particularly evident in the immunocompromised. Iatrogenic solid organ transplant, diabetes, autoimmunity requiring immunosuppressive therapy, HIV and hemoproliferative malignant disease or disorders and aging, are all associated with an increased risk of developing head and neck cancer (HNC) and worse outcomes [1][2][3][4][5][6][7][8][9][10][11]. Proliferating tumors utilize many forms of immunosuppression to tip the balance of immunoediting toward tumor progression [12].…”