Association between multiple sclerosis and cancer risk: An extensive review/meta and Mendelian randomization analyses

Qiangzhao Liu; Jian Kang; Yongsheng Yin; Jinling Zhang; Qiong Lian; Fenghai Zhou

doi:10.1016/j.msard.2023.104798

Association between multiple sclerosis and cancer risk: An extensive review/meta and Mendelian randomization analyses

Mult Scler Relat Disord. 2023 Aug:76:104798. doi: 10.1016/j.msard.2023.104798. Epub 2023 Jun 9.

Authors

Qiangzhao Liu¹, Jian Kang², Yongsheng Yin², Jinling Zhang³, Qiong Lian⁴, Fenghai Zhou²

Affiliations

¹ Department of Urology, Gansu Provincial Hospital, Lanzhou, Gansu 730000, PR China. Electronic address: liuqiangzhao2022@163.com.
² Department of Urology, Gansu Provincial Hospital, Lanzhou, Gansu 730000, PR China.
³ Department of Neurology, Gansu Provincial Hospital, Lanzhou, Gansu 730000, PR China.
⁴ Department of Radiology, Lanzhou University Second Hospital, Lanzhou, Gansu 730000, PR China.

PMID: 37315470
DOI: 10.1016/j.msard.2023.104798

Abstract

Background: Observational investigations examining cancer risk among multiple sclerosis (MS) patients have produced contradictory findings. Herein, we performed an extensive review and meta-analysis to evaluate the correlation and causation between MS and cancer incidence.

Methods: We systematically screened for published articles examining cancer incidences among MS patients within the Cochrane Library, PubMed, and Embase databases. Next, we employed STATA v.16.0 for data analysis. Following meta-analysis, we performed a two-sample Mendelian randomization (MR) analysis to uncover the underlying mechanism behind the MS-mediated regulation of certain cancers.

Results: Overall, we selected 18 articles encompassing 14 individual cancers incidences and a total of 368,952 patients for meta-analysis. Based on our analysis, there was reduced pancreatic (ES = 0.68; 95% CI: 0.49-0.93; I 2 = 0%) and ovarian cancer (ES = 0.65; 95% CI: 0.53-0.80; I 2 = 86.7%) co-occurrences among MS patients. Meanwhile, the incidences of breast (ES = 1.10; 95% CI: 1.01-1.21; I 2 = 60.9%) and brain cancers (ES = 1.94; 95% CI: 1.12-3.37; I 2 = 56.1%) were elevated among the same population. However, MR analysis revealed the opposite relation between MS and breast cancer risk (OR = 0.94392; 95% CI: 0.91011-0.97900, P = 0.002). Moreover, it revealed strong incidence of lung cancer (OR = 1.0004; 95% CI: 1.0001-1.0083, P = 0.001) among MS patients, as evidenced by the inverse variance weighting estimator. Lastly, MR found that other forms of cancers were not significantly related to MS.

Conclusions: Using meta-analysis, we demonstrated that MS patients exhibited enhanced pancreatic and ovarian cancer risk, and diminished breast and brain cancer risk. However, using MR analysis, we discovered an inverse relation between MS and breast cancer risk, and additionally saw an uptick in lung cancer co-occurrence among MS patients.

Keywords: Cancer incidence; Mendelian randomization analysis; Meta-analysis; Multiple sclerosis.

Publication types

Meta-Analysis
Review

MeSH terms

Brain Neoplasms*
Breast Neoplasms*
Female
Humans
Lung Neoplasms* / complications
Mendelian Randomization Analysis
Multiple Sclerosis* / complications
Multiple Sclerosis* / epidemiology
Ovarian Neoplasms* / etiology