MS patients at lower risk for some digestive cancers, study finds
Pancreatic, esophageal cancers less common in MS patients
While certain autoimmune diseases are linked to an increased risk of digestive system cancers, people with multiple sclerosis (MS) may be less likely to develop some of these malignancies, according to an analysis of published studies.
Researchers found that MS patients are at lower risk of developing pancreatic, esophageal, rectal, and colorectal cancers than people without MS. The reasons for that aren’t clear.
“Our results underline the need for targeted monitoring of patients with autoimmune diseases and the development of personalized cancer prevention programs,” Julia Reizner, a researcher at the University of Augsburg in Germany and the study’s first author, said in a university news story.
The study, “Evaluating the risk of digestive system cancer in autoimmune disease patients: a systematic review and meta-analysis focusing on bias assessment,” was published in eClinical Medicine.
Autoimmune conditions are diseases in which a person’s immune system mistakenly attacks the body’s own healthy tissues. Among them is MS, where these immune attacks lead to inflammatory damage in the brain and spinal cord.
Examining the risk factors
Research has suggested that various autoimmune diseases may be associated with an increased risk of cancers affecting the digestive system, such as colorectal, stomach, liver, esophageal, or pancreatic cancer.
Results from studies investigating cancer risk in people with MS have been variable, but some studies have suggested that certain digestive cancers may happen more often in the MS population.
The exact mechanisms underlying the relationships between autoimmune disease and digestive cancers aren’t established, but researchers think that long-term inflammation and the use of certain immune-suppressing medications could contribute.
“Gaining knowledge is essential to develop clinical surveillance strategies for these patients and to plan and implement personalized cancer prevention,” the researchers wrote. This is particularly important for younger people with autoimmune diseases, who are likely to live with their conditions for many years and receive long-term immunomodulatory treatments, they said.
The scientists analyzed data from 47 studies investigating the link between digestive system cancer and autoimmune diseases that frequently manifest at a younger age, including MS, lupus, celiac disease, and type 1 diabetes. Overall, they looked at more than 1.5 million cases of autoimmune disease.
The results showed that people with MS were at a 41% lower risk of esophageal cancer and 23% lower risk of pancreatic cancer, while the risk of rectal and colorectal cancers were reduced by 19% and 12%, respectively.
The three other autoimmune diseases included in the study were associated with an elevated risk of several types of digestive cancers.
Some studies have suggested that immune alterations in MS makes the immune system better equipped to find and destroy potential cancer cells. But it’s also possible that MS treatments and lifestyle factors have an impact on cancer risk.
“Whether the inverse association between MS and cancer of the digestive system … is a genuine phenomenon or is due to lifestyle factors or medication use needs to be the subject of further research,” the scientists wrote.
Nevertheless, the findings offer insights for physicians who are treating people with autoimmune diseases.
“There is a need to identify patients who are at higher risk for developing digestive system cancers and who would benefit most from individualized screening programs,” the researchers wrote. “The results could possibly be considered in clinical guidelines for the autoimmune diseases investigated.”
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