title: Are antibody deficiency disorders associated with a narrower range of cancers than other forms of immunodeficiency?
abstract: Analysis of cancer risk in primary immune deficiency (PID) offers insight into the relationship between immune function and cancer. Data on Australian patients (n = 1132) notified voluntarily to the Australasian Society of Clinical Immunology and Allergy PID Registry (1990-2008) were linked with national death and cancer registries. Person-years of follow-up commenced from up to 15 years before registration on the PID Registry or January 1982, the inception of national cancer registration. Site-specific, 5-year age-, sex-, calendar year-, and state-standardized incidence ratios (SIRs) with 95% confidence intervals (95% CIs) were calculated for all cancers except nonmelanocytic skin cancer. During an average of 16 person-years follow-up, a 1.6-fold excess relative risk of cancer was observed (n = 58; SIR 1.60, 95% CI 1.22-2.07) for all PID combined. Relative risk was increased for non-Hodgkin lymphoma (n = 16; SIR 8.82, 95% CI 5.04-14.30), leukemia (n = 4; SIR 5.36, 95% CI 1.46-13.73), and stomach cancer (n = 3; SIR 6.10, 95% CI 1.26-17.84). Excess cancer risk was observed for predominantly antibody deficiencies and other well-defined immunodeficiency syndromes. Results suggest that predominantly antibody deficiencies may be associated with a narrower range of solid cancers than immunodeficiency characterized by predominantly T-cell deficiency, such as iatrogenic and HIV-related immunodeficiency, although this requires confirmation in larger cohorts.
authors.affiliation: Prince of Wales Clinical School and Lowy Cancer Research Centre, Sydney, Australia. claire.vajdic@unsw.edu.au
authors.forename: Claire M
authors.initials: CM
authors.lastname: Vajdic
authors.forename: Limin
authors.initials: L
authors.lastname: Mao
authors.forename: Marina T
authors.initials: MT
authors.lastname: van Leeuwen
authors.forename: Philippa
authors.initials: P
authors.lastname: Kirkpatrick
authors.forename: Andrew E
authors.initials: AE
authors.lastname: Grulich
authors.forename: Sean
authors.initials: S
authors.lastname: Riminton
mesh_terms: D000293:Adolescent; D000328:Adult; D001315:Australia / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007153:Immunologic Deficiency Syndromes / Q000453:epidemiology* / Q000473:pathology / Q000628:therapy; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000453:epidemiology* / Q000473:pathology / Q000628:therapy; D012042:Registries; D012307:Risk Factors; D015996:Survival Rate; D055815:Young Adult