title: Investigating the association between allergen-specific immunoglobulin E, cancer risk and survival.
abstract: Prior findings linking allergy and cancer have been inconsistent, which may be driven by diverse assessment methods. We used serum specific immunoglobulin E (IgE) against common inhalant allergens that was assessed prior to cancer diagnosis in studying this association. We selected 8,727 Swedish men and women who had measurements of serum allergen-specific IgE and total IgE between 1992 and 1996. Multivariable Cox regression using age as a timescale was performed to assess the associations of IgE sensitization, defined by any levels of serum specific IgE ≥35 kU/L, with risk of overall and specific cancers. A test for trend was performed by assigning scores derived from allergen-specific IgE levels at baseline as an ordinal scale. Kaplan-Meier curves and log-rank test were used to assess cancer survival by IgE sensitization status. During a mean follow-up of 16 year, 689 persons were diagnosed with cancer. We found an inverse association between IgE sensitization and cancer risk, with a hazard ratio (HR) of 0.83 and 95% confidence intervals (CI) of 0.70-0.99. A similar trend was seen with specific IgE scores overall (Ptrend = 0.007) and in women (Ptrend = 0.01). Although IgE sensitization was not associated with risk of common site-specific cancers, serum specific IgE scores were inversely associated with melanoma risk in men and women combined, and with risk of female breast and gynecological cancers combined. No association with survival was observed. The association between circulating IgE levels and incident cancer may point toward a role of T-helper 2 (TH2)-biased response in development of some cancers.
authors.affiliation: Cancer Epidemiology Group, Division of Cancer Studies, King's College London, London, UK; Division of Hematology/Oncology, Faculty of Medicine, Gadjah Mada University, Yogyakarta, Indonesia.
authors.forename: Wahyu
authors.initials: W
authors.lastname: Wulaningsih
authors.affiliation: Cancer Epidemiology Group, Division of Cancer Studies, King's College London, London, UK; Department of Surgical Sciences, Uppsala University Hospital, Uppsala, Sweden; Regional Cancer Centre, Uppsala, Sweden.
authors.forename: Lars
authors.initials: L
authors.lastname: Holmberg
authors.affiliation: Cancer Epidemiology Group, Division of Cancer Studies, King's College London, London, UK; St. John's Institute of Dermatology, Division of Genetics and Molecular Medicine, Faculty of Life Sciences and Medicine, King's College London, NIHR Biomedical Research Centre at Guy's and St. Thomas's Hospitals and King's College London, London, UK.
authors.forename: Hans
authors.initials: H
authors.lastname: Garmo
authors.affiliation: St. John's Institute of Dermatology, Division of Genetics and Molecular Medicine, Faculty of Life Sciences and Medicine, King's College London, NIHR Biomedical Research Centre at Guy's and St. Thomas's Hospitals and King's College London , London, UK.
authors.forename: Sophia N
authors.initials: SN
authors.lastname: Karagiannis
authors.affiliation: Center of Allergy Research, Institute of Environmental Medicine, Karolinska Insitutet , Stockholm, Sweden.
authors.forename: Staffan
authors.initials: S
authors.lastname: Ahlstedt
authors.affiliation: Unit of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet , Stockholm, Sweden.
authors.forename: Håkan
authors.initials: H
authors.lastname: Malmstrom
authors.affiliation: Regional Cancer Centre, Uppsala, Sweden; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Mats
authors.initials: M
authors.lastname: Lambe
authors.affiliation: Unit of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; AstraZeneca R&D, Mölndal, Sweden.
authors.forename: Niklas
authors.initials: N
authors.lastname: Hammar
authors.affiliation: Unit of Cardiovascular Epidemiology, Institute of Environmental Medicine, Karolinska Institutet , Stockholm, Sweden.
authors.forename: Göran
authors.initials: G
authors.lastname: Walldius
authors.affiliation: Department of Medicine, Clinical Epidemiological Unit, Karolinska Institutet and CALAB Research , Stockholm, Sweden.
authors.forename: Ingmar
authors.initials: I
authors.lastname: Jungner
authors.affiliation: Richard Dimbleby Department of Cancer Research, Randall Division and Division of Cancer Studies, King's College London , London, UK.
authors.forename: Tony
authors.initials: T
authors.lastname: Ng
authors.affiliation: Cancer Epidemiology Group, Division of Cancer Studies, King's College London, London, UK; Unit of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Mieke
authors.initials: M
authors.lastname: Van Hemelrijck
keywords: Allergy; atopy; cancer; cohort; immunoglobulin E