title: Decreased risk of cancer in multiple sclerosis patients and analysis of the effect of disease modifying therapies on cancer risk.
abstract: BACKGROUND
  Although dysimmunity is considered an important link between multiple sclerosis (MS), family history and cancer risk, their relationship to the use of disease modifying therapies (DMT) is not fully understood.
  
  
  OBJECTIVE
  To assess the observed versus expected number of cancers in MS patients, and family history of cancer, among DMT users and DMT naïve patients.
  
  
  METHODS
  Cancer, DMT use, and family history of cancer were assessed using the New York State Multiple Sclerosis Consortium (NYSMSC) registry. Self-reported cancers in MS patients were tested for associations with DMT use, family history of cancer and other factors. Expected number of cancer cases was estimated using age- and gender-specific prevalence and incidence rates from the general population.
  
  
  RESULTS
  The prevalence of cancer in males and females in the NYSMSC cohort was lower than expected (p<0.001). Patients with cancer were older at MS diagnosis and more likely to be female (p<0.001). MS patients with a personal history of cancer were more likely to report DMT use (p<0.001) and family history of cancer (p<0.001). Multivariable analysis did not support a higher risk of cancer after DMT initiation.
  
  
  CONCLUSIONS
  We report a lower than expected number of cancer cases in MS patients compared to the general population. MS patients with a personal history of cancer were more likely to report DMT use suggesting that DMTs may abrogate the lower incidence of cancer in MS.
authors: Jacobs Comprehensive MS Treatment and Research Center, University at Buffalo, Buffalo, NY, USA.
authors: Deeya
authors: D
authors: Gaindh
authors: Jacobs Comprehensive MS Treatment and Research Center, University at Buffalo, Buffalo, NY, USA; New York State MS Consortium, University at Buffalo, Buffalo, NY, USA.
authors: Katelyn S
authors: KS
authors: Kavak
authors: Jacobs Comprehensive MS Treatment and Research Center, University at Buffalo, Buffalo, NY, USA; New York State MS Consortium, University at Buffalo, Buffalo, NY, USA; Department of Neurology, State University of New York at Buffalo, Buffalo, NY, USA.
authors: Barbara
authors: B
authors: Teter
authors: Jacobs Comprehensive MS Treatment and Research Center, University at Buffalo, Buffalo, NY, USA; New York State MS Consortium, University at Buffalo, Buffalo, NY, USA; Department of Neurology, State University of New York at Buffalo, Buffalo, NY, USA.
authors: Caila B
authors: CB
authors: Vaughn
authors: Department of Neurology, State University of New York at Buffalo, Buffalo, NY, USA.
authors: Diane
authors: D
authors: Cookfair
authors: Department of Medicine, Roswell Park Cancer Institute, Buffalo, NY, USA.
authors: Theresa
authors: T
authors: Hahn
authors: Jacobs Comprehensive MS Treatment and Research Center, University at Buffalo, Buffalo, NY, USA; New York State MS Consortium, University at Buffalo, Buffalo, NY, USA; Department of Neurology, State University of New York at Buffalo, Buffalo, NY, USA. Electronic address: bweinstock-guttman@kaleidahealth.org.
authors: Bianca
authors: B
authors: Weinstock-Guttman
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D020022:Genetic Predisposition to Disease; D006801:Humans; D007155:Immunologic Factors / Q000009:adverse effects* / Q000627:therapeutic use*; D015994:Incidence; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000188:drug therapy* / Q000453:epidemiology; D009369:Neoplasms / Q000453:epidemiology*; D009518:New York / Q000453:epidemiology; D015995:Prevalence; D012042:Registries; D012189:Retrospective Studies; D012306:Risk; D057566:Self Report; D055815:Young Adult
chemical_list: D007155:Immunologic Factors
keywords: Cancer; Disease modifying therapy (DMT); Multiple sclerosis