title: Cancer and autoimmunity: Harnessing longitudinal cohorts to probe the link.
abstract: In many autoimmune rheumatic diseases, there is an increased risk of cancer compared to the general population. While reasons for this increased risk have not been elucidated, it has been hypothesized that the link between cancer and autoimmunity may be bidirectional. For instance, chronic inflammation and damage from the rheumatic disease or its therapies may trigger malignant transformation; conversely, antitumor immune responses targeting cancers may become cross-reactive resulting in autoimmunity. In rare rheumatic diseases, longitudinal observational studies can play a critical role in studying these complex relationships, thereby enabling investigators to quantify the extent of cancer risk, identify unique clinical phenotypes associated with cancer, investigate the biological link between these conditions, and define optimal strategies for screening and treatment of the underlying cancer. In this review, we discuss recent data on cancer in the rheumatic diseases and suggest a research agenda to address several gaps in our current knowledge base.
authors.affiliation: Resident Internal Medicine, McGill University, Royal Victoria Hospital, Glen Site, Rm D05.5840, 1001 Decarie Boulevard, Montreal, QC H4A 3J1, Canada. Electronic address: giordano.egiziano@mail.mcgill.ca.
authors.forename: Giordano
authors.initials: G
authors.lastname: Egiziano
authors.affiliation: Division of Clinical Epidemiology, McGill University Health Center, 687 Pine Avenue, V Building, Montreal, QC H3A 1A1, Canada. Electronic address: sasha.bernatsky@mcgill.ca.
authors.forename: Sasha
authors.initials: S
authors.lastname: Bernatsky
authors.affiliation: Johns Hopkins Scleroderma Center, 5501 Hopkins Bayview Circle, Room 1B.15, Baltimore, MD 21224, USA. Electronic address: Ami.Shah@jhmi.edu.
authors.forename: Ami A
authors.initials: AA
authors.lastname: Shah
mesh_terms: D001327:Autoimmune Diseases / Q000276:immunology*; D015551:Autoimmunity; D006801:Humans; D007249:Inflammation / Q000276:immunology; D009369:Neoplasms / Q000276:immunology*; D012216:Rheumatic Diseases / Q000276:immunology*
keywords: Autoimmunity; Cancer; Epidemiology; Observational cohorts