| Title: | Differential impact of immune-mediated inflammatory diseases before versus after cancer on patient survival: a nationwide cohort study |
| Journal: | Rheumatology |
| Published: | 8 May 2025 |
| Pubmed: | https://pubmed.ncbi.nlm.nih.gov/40341467/ |
| DOI: | https://doi.org/10.1093/rheumatology/keaf213 |
Publication 15399
WARNING: the interactive features of this website use CSS3, which your browser does not support. To use the full features of this website, please update your browser.
Abstract
OBJECTIVES: The relationship between immune-mediated inflammatory diseases (IMIDs) and cancer survival appears to be irregular and complex. However, the impact of IMIDs before vs after cancer onset on patient survival has not been clearly defined. We aimed to evaluate the relationship between IMIDs diagnosed before or after cancer onset and both all-cause and cause-specific mortality in cancer.</p>
METHODS: This nationwide cohort study utilized data from the UK Biobank, involving adults aged 37-73 years, with follow-up conducted until 31 September 2021. We assessed IMIDs diagnosed either prior to or after cancer in relation to all-cause mortality and cause-specific mortality.</p>
RESULTS: A total of 93 884 cancer participants (mean [standard deviation, SD] age: 60.2 [6.9] years; 51% female) were included in this cohort study. Compared with cancer patients without IMIDs, those with IMIDs diagnosed before cancer were associated with an increased risk of all-cause mortality (hazard ratio [HR], 1.78; 95% confidence interval [CI], 1.71-1.86) and cancer-specific mortality (HR, 1.62; 95% CI, 1.55-1.71). Conversely, those with IMIDs diagnosed after cancer exhibited protective effects on all-cause mortality (HR, 0.79; 95% CI, 0.75-0.83) and cancer mortality (HR, 0.69; 95% CI, 0.66-0.73). These findings remained consistent after conducting subgroup analyses based on the timing of immune checkpoint inhibitor introduction or using propensity score matching. We also mapped the association of individual IMIDs, both pre- and post-diagnosis, with all-cause mortality across various cancer types. IMIDs diagnosed after cancer showed diminished or reversed effects on mortality compared with those diagnosed prior to cancer.</p>
CONCLUSIONS: Our study highlights the differential impacts of IMIDs diagnosed before and after cancer onset on survival outcomes. While pre-existing IMIDs appear to exacerbate mortality risk, newly diagnosed IMIDs post-cancer may confer a survival advantage. Clinicians should consider the implications of IMIDs management in cancer patients to optimize treatment and improve overall survival.</p>
11 Keywords
- Adult
- Aged
- Cause of Death
- Cohort Studies
- Female
- Humans
- Inflammation
- Male
- Middle Aged
- Neoplasms
- United Kingdom
7 Authors
- Guangtong Deng
- Ziyu Guo
- Jiayuan Le
- Yuming Sun
- Danyao Chen
- Furong Zeng
- Minxue Shen
Enabling scientific discoveries that improve human health