Effect of autoimmune diseases on risk and survival in histology-specific lung cancer

Hemminki, Kari; Liu, Xiangdong; Ji, Jianguang; Sundquist, Jan; Sundquist, Kristina

doi:10.1183/09031936.00222911

Cited by 54 publications

(56 citation statements)

References 41 publications

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“…Cancer risk is elevated in patients with obesity; in patients with diabetes and resulting insulin resistance and chronic hyperinsulinemia;46–49 and in patients with inherited, acquired (eg, from HIV/AIDS), or drug-induced (eg, from treatment with steroids or biologics) immunosuppression 50,51. Some of these risk factors also may be associated with rate of cancer growth and cancer grade/differentiation and thus with prognosis.…”

Section: Resultsmentioning

confidence: 99%

The impact of comorbidity on cancer survival: a review

Søgaard¹,

Thomsen²,

Bossen³

et al. 2013

CLEP

470

403

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BackgroundA number of studies have shown poorer survival among cancer patients with comorbidity. Several mechanisms may underlie this finding. In this review we summarize the current literature on the association between patient comorbidity and cancer prognosis. Prognostic factors examined include tumor biology, diagnosis, treatment, clinical quality, and adherence.MethodsAll English-language articles published during 2002–2012 on the association between comorbidity and survival among patients with colon cancer, breast cancer, and lung cancer were identified from PubMed, MEDLINE and Embase. Titles and abstracts were reviewed to identify eligible studies and their main results were then extracted.ResultsOur search yielded more than 2,500 articles related to comorbidity and cancer, but few investigated the prognostic impact of comorbidity as a primary aim. Most studies found that cancer patients with comorbidity had poorer survival than those without comorbidity, with 5-year mortality hazard ratios ranging from 1.1 to 5.8. Few studies examined the influence of specific chronic conditions. In general, comorbidity does not appear to be associated with more aggressive types of cancer or other differences in tumor biology. Presence of specific severe comorbidities or psychiatric disorders were found to be associated with delayed cancer diagnosis in some studies, while chronic diseases requiring regular medical visits were associated with earlier cancer detection in others. Another finding was that patients with comorbidity do not receive standard cancer treatments such as surgery, chemotherapy, and radiation therapy as often as patients without comorbidity, and their chance of completing a course of cancer treatment is lower. Postoperative complications and mortality are higher in patients with comorbidity. It is unclear from the literature whether the apparent undertreatment reflects appropriate consideration of greater toxicity risk, poorer clinical quality, patient preferences, or poor adherence among patients with comorbidity.ConclusionDespite increasing recognition of the importance of comorbid illnesses among cancer patients, major challenges remain. Both treatment effectiveness and compliance appear compromised among cancer patients with comorbidity. Data on clinical quality is limited.

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Section: Resultsmentioning

confidence: 99%

The impact of comorbidity on cancer survival: a review

Søgaard¹,

Thomsen²,

Bossen³

et al. 2013

CLEP

470

403

View full text Add to dashboard Cite

show abstract

“…in a study involving 7624 SLE patients identified from the Swedish Hospital Discharge Registry demonstrated an even higher incidence of all forms of lung cancer (SIR 2.47, 95% CI, 1.97, 3.05)[33], and they delineated the rates of specific histologic types of lung malignancies in SLE patients. The risk was most significantly increased for small cell lung cancer (SIR 3.38, 95% CI, 1.89, 5.59), followed by squamous cell carcinoma (SIR 2.97, 95% CI, 1.86, 4.50), large cell carcinoma (SIR 2.55, 95% CI, 1.53, 3.99), and adenocarcinoma (SIR 2.12, 95% CI, 1.34, 3.18) [33]. The SMR was also increased for small cell lung cancer in SLE patients (SMR 2.69, 95% CI, 2.11, 3.38), suggesting increased mortality in SLE patients with this form of lung cancer [33].…”

Section: Lung Malignanciesmentioning

confidence: 99%

Malignancies in systemic lupus erythematosus

Goobie

Bernatsky

Ramsey‐Goldman

et al. 2015

Current Opinion in Rheumatology

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Purpose of Review Patients with systemic lupus erythematosus (SLE) have altered incidences of certain malignancies as compared to the general population. This review summarizes the recent literature on risk of malignancy in SLE and proposed mechanisms for these altered susceptibilities. Recent Findings Recent studies have confirmed previous data showing an increased risk of non-Hodgkin’s lymphoma, lung, liver, vulvar/vaginal, and thyroid malignancies, while demonstrating a decreased risk of breast and prostate cancer. Lymphomagenesis in SLE has been linked to increased activity of multiple inflammatory cytokines as well as possible viral etiologies. The decreased rates of hormone-sensitive cancers such as breast and prostate is speculated to be related to the presence of lupus autoantibodies and down-regulation of certain proteins in SLE. This knowledge has been utilized to investigate new therapeutic modalities for these malignancies. Summary Recent data confirm previously reported altered malignancy rates in SLE. Most striking in recent years are publications further elucidating mechanisms underlying cancer development in SLE, and subsequent investigations of potential therapeutics modulating these pathways.

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“…A history of a few specific autoimmune diseases has been found to increase mortality in patients with certain digestive tract cancers [17], but does not seem to influence prognosis in other cancer types, e.g., lung cancer [18]. In a large study on patients with Hodgkin lymphoma, a prior diagnosis of autoimmune disease was associated with poorer survival [25].…”

Section: Introductionmentioning

confidence: 99%

History of autoimmune disease is associated with impaired survival in multiple myeloma and monoclonal gammopathy of undetermined significance: a population-based study

et al. 2016

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Multiple myeloma (MM) is a plasma cell disorder preceded by monoclonal gammopathy of undetermined significance (MGUS). Incidence of MM and MGUS is higher among patients with autoimmune disease. The aim of this study was to determine whether a history of autoimmunity has an impact on survival in MM and MGUS. Using highquality national Swedish registries, we identified 8367 patients with MM, 18,768 patients with MGUS, and 110,251 matched control subjects, and obtained information on previous autoimmune disease in patients and controls. Cox regression was used to calculate hazard ratios (HRs) for overall survival with 95 % confidence intervals (CIs). In patients with MM and a prior autoimmune disease, the risk of death was significantly increased, HR = 1.2 (95 % CI 1.2-1.3) compared to MM patients with no history of autoimmunity. In MGUS patients, a prior autoimmune disease was associated with a significantly 1.4-fold elevated risk of death (95 % CI 1.3-1.4). When analyzing different types of autoimmune diseases, a history of ulcerative colitis had a stronger impact on survival in MM than in controls. Our findings that a history of autoimmune disease has a negative impact on survival in MM and MGUS could be due to shared underlying common genetic factors, or that patients with a history of autoimmunity develop more severe cases of MM and MGUS, or cumulative comorbidity in the individual. Our results suggest that more attention should be paid to comorbidity as a prognostic factor in MGUS and MM, and underlines the need for studies aimed at tailoring therapy according to comorbidity.

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Effect of autoimmune diseases on risk and survival in histology-specific lung cancer

Cited by 54 publications

References 41 publications

The impact of comorbidity on cancer survival: a review

The impact of comorbidity on cancer survival: a review

Malignancies in systemic lupus erythematosus

History of autoimmune disease is associated with impaired survival in multiple myeloma and monoclonal gammopathy of undetermined significance: a population-based study

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