Abstract LB144: The nationwide population-based cohort study on the risk of immune-mediated diseases and risk of cancer in KOREA
Authors: Youn Jiyeong , Lee Jihoon , Kwak Yujin , Yang Soyoun , Yuk Minju , Song Nan 
Published: April 2023

Background: Immune-mediated diseases (IMDs) constitute a clinically heterogeneous group of disorders, affecting up to 5%-7% of the population worldwide. Disorders caused by IMDs are a group of diseases caused by abnormal activities of immune cells, which overreact or attack the body to show extreme inflammatory reactions or lose the ability to recognize and counter tumor cells. There is increasing evidence that IMDs play an important role in carcinogenesis and associated with the higher risk of cancers. To provide nation-wide evidence on the link between IMDs and cancer, this study evaluated the association between IMD and risk of cancer using the National Health Insurance Service-National Sample Cohort (NHIS-NSC) in Korea.

Method: Among a total of 1,137,861 cohorts registered between 2002 and 2019 from the NHIS-NSC, the cohorts with first cancer diagnosis at the time of death were excluded and 1,056,170 cohorts were included in the analysis. IMD and cancer cases were identified as at least one hospitalization or two outpatient visits using the Korean Standard Classification of Diseases-8 (KCD-8) codes. We required the IMD diagnosis to be present at least 12 months before the cancer diagnosis. The associations of overall and 47 specific IMDs with overall and 75 specific cancer risk were estimated by relative risks (RRs) and 95% confidence interval (95% CI) using a log-binomial regression model adjusted for sex and age.

Results: Total 44,329 (4.20%) IMD cases were identified. A total of 3,094 (6.97%) cancer cases were documented in IMDs and 51,056 (5.09%) cancer cases in non-IMDs. Overall IMD was significantly associated with the 1.38-fold higher risk of cancer (95% CI=1.33-1.43). Specifically, 32 out of 47 (68.09%) IMDs showed the statistically significant association with the increased risk including relatively strong or moderate associations; psoriatic (RR=9.75; 95% CI=2.43-38.99), rheumatic heart disease (RR=6.71; 95% CI=4.07-11.10), primary biliary cholangitis (RR=5.00; 95% CI=4.35-5.75), systemic scleroderma (RR=4.18; 95% CI=2.34-7.45), giant cell arteritis (RR=4.17; 95% CI,1.53-11.39), sarcoidosis (RR=3.61; 95% CI=1.63-7.96), aplastic anemia (RR=3.54; 95% CI=1.01-12.43), Wegener’s granulomatosis (RR=3.07; 95% CI=1.09-8.69), polymyositis (RR=2.92; 95% CI=1.91-4.48), polymyalgia rheumatica (RR=2.84; 95% CI=2.18-3.72), systemic lupus erythematosus (RR=2.84; 95% CI=1.77-4.53). When cancers were classified by body system, the more prominent associations between overall IMD and cancers in respiratory-intrathoracic organs (RR=3.73; 95% CI=2.85-4.88), urinary tract (RR=1.62; 95% CI=1.23-2.14), thyroid and other endocrine glands (RR=1.58; 95% CI=1.46-1.71), and lip-oral-cavity-pharynx (RR=1.55; 95% CI=1.12-2.15) were observed.

Conclusion: This retrospective cohort study provides the nation-wide population-based evidence that IMDs are associated with the increased risk of cancers supporting the immunomodulation in carcinogenesis.

Citation Format: Jiyeong Youn, Jihoon Lee, Yujin Kwak, Soyoun Yang, Minju Yuk, Nan Song. The nationwide population-based cohort study on the risk of immune-mediated diseases and risk of cancer in KOREA [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 2 (Clinical Trials and Late-Breaking Research); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(8_Suppl):Abstract nr LB144.