A systematic review of the incidence and prevalence of cancer in multiple sclerosis

Ruth Ann Marrie; Nadia Reider; Jeffrey Cohen; Olaf Stuve; Maria Trojano; Per Soelberg Sorensen; Stephen C Reingold; Gary Cutter

doi:10.1177/1352458514564489

A systematic review of the incidence and prevalence of cancer in multiple sclerosis

Mult Scler. 2015 Mar;21(3):294-304. doi: 10.1177/1352458514564489. Epub 2014 Dec 22.

Authors

Ruth Ann Marrie¹, Nadia Reider², Jeffrey Cohen³, Olaf Stuve⁴, Maria Trojano⁵, Per Soelberg Sorensen⁶, Stephen C Reingold⁷, Gary Cutter⁸

Affiliations

¹ Department of Internal Medicine, University of Manitoba, Winnipeg, Canada/Department of Community Health Sciences, University of Manitoba, Winnipeg, Canada rmarrie@hsc.mb.ca.
² Department of Internal Medicine, University of Manitoba, Winnipeg, Canada.
³ Mellen Center for MS Treatment and Research, Cleveland Clinic, Cleveland, OH, USA.
⁴ Department of Neurology and Neurotherapeutics, University of Texas Southwestern, Dallas, TX, USA.
⁵ Department of Basic Medical Sciences, Neurosciences and Sense Organs, University of Bari, Italy.
⁶ Department of Neurology, Copenhagen University Hospital Rigshospitalet, Denmark.
⁷ Scientific and Clinical Review Associates, LLC, Salisbury, CT, USA.
⁸ Department of Biostatistics, University of Alabama at Birmingham, USA.

Abstract

Background: Studies of cancer incidence and prevalence in multiple sclerosis (MS) have produced conflicting results.

Objective: To estimate the incidence and prevalence of cancer in persons with MS and review the quality of included studies.

Methods: We searched the PUBMED, SCOPUS, Web of Knowledge, and EMBASE databases, conference proceedings, and reference lists of all articles retrieved. Abstracts were screened for relevance by two reviewers. Data from included articles were captured using a standardized form, and the abstraction was verified by a second reviewer. We assessed quality of the included studies. We quantitatively assessed studies using the I (2) statistic, and conducted meta-analyses for population-based studies.

Results: We identified 38 studies. Estimates for incidence and prevalence varied substantially for most cancers. In population-based studies, cervical, breast, and digestive cancers had the highest incidence. The risk of meningiomas and urinary system cancers appeared higher than expected, while the risks of pancreatic, ovarian, prostate and testicular cancer were lower than expected.

Conclusion: The complexity of understanding cancer risk in MS is augmented by inconsistencies in study design, and the relative paucity of age, sex and ethnicity-specific risk estimates from which the strong impact of age on the incidence of cancers can be assessed.

Keywords: Multiple sclerosis; cancer; comorbidity; incidence; prevalence; systematic review.

Publication types

Research Support, Non-U.S. Gov't
Review
Systematic Review

MeSH terms

Comorbidity
Humans
Incidence
Multiple Sclerosis / epidemiology*
Neoplasms / epidemiology*
Prevalence

Grants and funding

Canadian Institutes of Health Research/Canada