Cancer Res Treat.  2019 Jul;51(3):841-850. 10.4143/crt.2019.151.

Autoimmune Diseases and Gastric Cancer Risk: A Systematic Review and Meta-Analysis

• Song M
• Latorre G
• Ivanovic-Zuvic D
• Camargo MC
• Rabkin CS

• KMID: 2454277
• DOI: http://doi.org/10.4143/crt.2019.151

Abstract

PURPOSE
Autoimmunity is an alternative etiology of gastric inflammation, the initiating event in the gastric carcinogenic cascade. This mechanism may be an increasingly important cause of gastric cancer with the waning prevalence of its primary etiologic factor, chronic Helicobacter pylori infection.
MATERIALS AND METHODS
PubMed and EMBASE were searched up to September 2018. Autoimmunity and 96 specific manifestations were considered for associations with gastric cancer risk. Random effects analysis was used to calculate pooled relative risk estimates (RR) and 95% confidence intervals (CI).
RESULTS
We found a total of 52 observational studies representing 30 different autoimmune diseases. Overall, the presence of an autoimmune condition was associated with a gastric cancer pooled RR of 1.37 (95% CI, 1.24 to 1.52). Among the 24 autoimmune conditions with two or more independent reports, nine were significantly associated with increased gastric cancer risk: dermatomyositis (RR, 3.69; 95% CI, 1.74 to 7.79), pernicious anemia (RR, 2.84; 95% CI, 2.30 to 3.50), Addison disease (RR, 2.11; 95% CI, 1.26 to 3.53), dermatitis herpetiformis (RR, 1.74; 95% CI, 1.02 to 2.97; n=3), IgG4-related disease (RR, 1.69; 95% CI, 1.00 to 2.87), primary biliary cirrhosis (RR, 1.64; 95% CI, 1.13 to 2.37), diabetes mellitus type 1 (RR, 1.41; 95% CI, 1.20 to 1.67), systemic lupus erythematosus (RR, 1.37; 95% CI, 1.01 to 1.84), and Graves disease (RR, 1.27; 95% CI, 1.06 to 1.52).
CONCLUSION
Our analysis documents the wide range of autoimmune diseases associated with gastric cancer. These associations may reflect unreported links between these conditions and autoimmune gastritis. Further studies are warranted to investigate potential causal mechanisms.

Keyword

Stomach neoplasms; Autoimmune diseases; Epidemiology; Risk

MeSH Terms

Addison Disease
Anemia, Pernicious
Autoimmune Diseases*
Autoimmunity
Dermatitis Herpetiformis
Dermatomyositis
Diabetes Mellitus
Epidemiology
Gastritis
Graves Disease
Helicobacter pylori
Inflammation
Liver Cirrhosis, Biliary
Lupus Erythematosus, Systemic
Prevalence
Stomach Neoplasms*

Figure

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  Fig. 1. Random effects summary relative risk (RR) and 95% confidence interval (CI) for gastric cancer among individuals with pernicious anemia [11,12,17-28].

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  Fig. 2. Random effects summary relative risk (RR) and 95% confidence interval (CI) for gastric cancer among individuals with diabetes mellitus type 1 [11,29-34].

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  Fig. 3. Random effects summary relative risk (RR) and 95% confidence interval (CI) for gastric cancer among individuals with systemic lupus erythematosus [11,12,35-37].

Reference

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