Cancer risk in immune-mediated inflammatory diseases (IMID)

Abstract

Inflammation and cancer have a profound yet ambiguous relationship. Inflammation - especially chronic inflammation - has protumorigenic effects, but inflammatory cells also mediate an immune response against the tumor and immunosuppression is known to increase the risk for certain tumors.This article reviews current literature on the role of inflammation in cancer and the cancer risk in immune-mediated inflammatory diseases (IMIDs). We discuss the effect on cancer risk of different drug classes used in the treatment of IMIDs treatment, including biologicals such as tumor necrosis factor (TNF) inhibitors.Overall cancer incidence and mortality risk are similar to the general population in inflammatory bowel disease (IBD), and slightly increased for rheumatoid arthritis and psoriasis, with risk profiles differing for different tumor types. Increased risk for non-melanoma skin cancer is associated with thiopurine treatment in IBD, with the combination of anti-TNF and methotrexate in rheumatoid arthritis and with PUVA, cyclosporine and anti-TNF treatment in psoriasis. Data on the safety of using biologic or immunosuppressant therapy in IMID patients with a history of cancer are scarce.This review provides clinicians with a solid background to help them in making decisions about treatment of immune-mediated diseases in patients with a tumor history.This article is related to another review article in Molecular Cancer: http://www.molecular-cancer.com/content/12/1/86.

Lung cancer in connective tissue disease-associated interstitial lung disease: clinical features and impact on outcomes

“…The results of several studies have indicated that chronic inflammation can initiate tumor development by causing DNA damage or making cell susceptible to mutagens (29). Furthermore, inflammatory mediators, such as tumor necrosis factor, interleukin-1, interleukin-6, growth factors, chemokines, and proteases, can promote the development of cancer via proliferative, anti-apoptotic, and pro-angiogenic effects on the epithelium (30).…”

Anti-Inflammatory Effects of β-Glucan in Cancer Related Fatigue

“…Expression of inflammation and immunity-mediated inflammatory diseases can result in inadequate and excessive immune response with cytokine disregulation and induction of acute or chronic immune reaction. These reactions can induce both pro-and antitumorigennic effects, which subsequently can persist and become inducer of progression or regression of cancer disease [1].…”

“…Prevalence of these diseases is rather high and involves 5-7% of the population in developed countries. The need to constantly monitor the immune reactions of these patients is based on the high risk of development of cancer [1][2][3][4].…”

Uveitic macular edema

“…52 An increased risk of non-melanoma skin cancer has been found associated with the use of a combination of anti-TNF and MTX in RA and with the use of PUVA, cyclosporine, and anti-TNF in psoriasis while the risk of melanoma is slightly increased. 53,54 Thus, biotherapies could be classified according to their potential oncogenic AEs.…”