title: Cancer risk in immune-mediated inflammatory diseases (IMID).
abstract: Inflammation and cancer have a profound yet ambiguous relationship. Inflammation - especially chronic inflammation - has protumorigenic effects, but inflammatory cells also mediate an immune response against the tumor and immunosuppression is known to increase the risk for certain tumors.This article reviews current literature on the role of inflammation in cancer and the cancer risk in immune-mediated inflammatory diseases (IMIDs). We discuss the effect on cancer risk of different drug classes used in the treatment of IMIDs treatment, including biologicals such as tumor necrosis factor (TNF) inhibitors.Overall cancer incidence and mortality risk are similar to the general population in inflammatory bowel disease (IBD), and slightly increased for rheumatoid arthritis and psoriasis, with risk profiles differing for different tumor types. Increased risk for non-melanoma skin cancer is associated with thiopurine treatment in IBD, with the combination of anti-TNF and methotrexate in rheumatoid arthritis and with PUVA, cyclosporine and anti-TNF treatment in psoriasis. Data on the safety of using biologic or immunosuppressant therapy in IMID patients with a history of cancer are scarce.This review provides clinicians with a solid background to help them in making decisions about treatment of immune-mediated diseases in patients with a tumor history.This article is related to another review article in Molecular Cancer: http://www.molecular-cancer.com/content/12/1/86.
authors.affiliation: Department of Rheumatology, Ghent University, 0K12, De Pintelaan 185, Ghent B-9000, Belgium. filip.dekeyser@ugent.be.
authors.forename: Rudi
authors.initials: R
authors.lastname: Beyaert
authors.forename: Laurent
authors.initials: L
authors.lastname: Beaugerie
authors.forename: Gert
authors.initials: G
authors.lastname: Van Assche
authors.forename: Lieve
authors.initials: L
authors.lastname: Brochez
authors.forename: Jean-Christophe
authors.initials: JC
authors.lastname: Renauld
authors.forename: Manuelle
authors.initials: M
authors.lastname: Viguier
authors.forename: Veronique
authors.initials: V
authors.lastname: Cocquyt
authors.forename: Guy
authors.initials: G
authors.lastname: Jerusalem
authors.forename: Jean-Pascal
authors.initials: JP
authors.lastname: Machiels
authors.forename: Hans
authors.initials: H
authors.lastname: Prenen
authors.forename: Pierre
authors.initials: P
authors.lastname: Masson
authors.forename: Edouard
authors.initials: E
authors.lastname: Louis
authors.forename: Filip
authors.initials: F
authors.lastname: De Keyser
mesh_terms: D000818:Animals; D001172:Arthritis, Rheumatoid / Q000188:drug therapy / Q000276:immunology / Q000473:pathology; D063646:Carcinogenesis / Q000276:immunology*; D006801:Humans; D007155:Immunologic Factors / Q000009:adverse effects / Q000627:therapeutic use; D007249:Inflammation / Q000276:immunology; D015212:Inflammatory Bowel Diseases / Q000188:drug therapy / Q000276:immunology / Q000473:pathology; D008180:Lupus Erythematosus, Systemic / Q000188:drug therapy / Q000276:immunology / Q000473:pathology; D009369:Neoplasms / Q000209:etiology / Q000276:immunology*; D011565:Psoriasis / Q000188:drug therapy / Q000276:immunology / Q000473:pathology; D012307:Risk Factors
chemical_list: D007155:Immunologic Factors