MS May Influence Timely Cancer Screenings, Diagnosis: Study
Breast cancer is less likely to be detected through a routine cancer screening for women with multiple sclerosis (MS), while colorectal cancer is more likely to be detected at an early stage in MS patients compared with those without the disease, a Canadian study found.
“Understanding the pathways to earlier detection in both cancers is critical to developing and planning interventions to ameliorate outcomes for people with MS and cancer,” the researchers wrote.
The study, “Multiple Sclerosis and the Cancer Diagnosis: Diagnostic Route, Cancer Stage, and the Diagnostic Interval in Breast and Colorectal Cancer,” was published in Neurology.
“MS can be a debilitating disease and mobility issues may make it difficult for people with MS to get to regular cancer screenings,” Ruth Ann Marrie, MD, PhD, the study’s senior author of the University of Manitoba, Winnipeg, in Canada, said in a press release.
“We conducted this study because little is known about whether having MS plays a role in getting regular cancer screenings. Early detection and timely diagnosis are important because they can affect a person’s cancer survival,” Marrie, who is also a member of the American Academy of Neurology, said.
Marrie and her colleagues evaluated healthcare records from MS patients and the general population who had breast or colorectal cancer in Ontario, Canada, looking at healthcare data for 14.8 million people. They found records of 351 women with MS who had breast cancer and compared them with 1,404 age-matched women without MS who also had breast cancer.
In women with MS, breast cancer was detected by a routine screening test, called mammogram, in 29% of the cases (103 women). In women without MS, the same screening test was able to detect cancer in 38% of the cases (529 women). For the remaining women, cancer was detected when they reported to the clinic with symptoms.
These findings translated into 32% lower odds of breast cancer being detected by a screening test in MS patients compared with those without MS.
“Disability from MS increases with age, as does cancer risk, so it is likely that those with MS may find it more difficult to get regular mammograms as they get older,” Marrie said.
The team also look at records from 54 MS patients with colorectal cancer and 216 people without MS who had colorectal cancer.
Findings showed that MS patients were twice as likely to have their cancer detected when it was at stage 1 — the earliest stage of cancer in which the disease has not yet spread throughout the body — compared with those without MS.
This could be because MS patients are already receiving care for their bowel symptoms related to MS, Marrie suggested.
“There is a high occurrence of bowel symptoms and gastrointestinal disorders in patients with MS, which could lead to shared symptoms with colorectal cancer,” Marrie said. “Increased gastrointestinal exams may help detect colorectal cancer sooner.”
In both cancer types, the time it took for MS patients to receive a cancer diagnosis after reporting to the doctor was similar to the interval in people without MS.
Researchers also found that MS-associated disability could affect patients’ ability to receive timely screenings. The study showed that 21% of MS patients with breast cancer and 33% of those with colorectal cancer had disability levels significant enough to require long-term or at-home care.
“More research is needed regarding the role of MS-related disability on screenings,” Marrie said.
The study did not account for the time from when individuals first noticed cancer symptoms to when they told their physicians, making it one of its limitations.
Data regarding race and ethnicity, which can significantly influence access to cancer screening, were not available for this study, and should be examined in the future, Marrie said.
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