International journal of surgery (London, England) · 2025
Association of different autoimmune diseases with gastric cancer incidence and risk: a global population-based analysis.
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Cheng Ji, Cai Ming, Wang Guobin
Аннотация
BACKGROUND: A dysregulated immune system could become a vital trigger for gastric carcinogenesis.
METHODS: Literature retrieval was performed based on PubMed, Web of Science, and Embase from inception to January 2025. Cohort studies investigating the risk ratio (RR) or incidence of gastric cancer among patients with autoimmune disorders were eligible. Relative risk was the primary endpoint [RR with 95% confidence interval (CI)], while incidence was the secondary endpoint.
RESULTS: A total of 285 studies were included, containing 61 556 078 participants. Overall pooled RR was 1.158 (95% CI 1.098-1.222, P < 0.001). Patients with autoimmune gastritis (3.066, P < 0.001), systemic sclerosis (1.788, P = 0.010), type 1 diabetes (1.411, P < 0.001), sarcoidosis (1.388, P = 0.004), and psoriasis (1.194, P = 0.001) were strongly associated with a higher risk of gastric cancer. Meanwhile, patients with dermatomyositis (2.100, P = 0.034) and systemic lupus erythematosus (1.296, P = 0.038) were also associated with increased risk of gastric cancer, despite smaller effect sizes and higher P values. Subgroup analyses based on sex and geographical regions were also conducted.
CONCLUSION: Autoimmune diseases were associated with increased gastric cancer risk, especially autoimmune gastritis, systemic sclerosis, type 1 diabetes, sarcoidosis, and psoriasis. Patients with dermatomyositis and systemic lupus erythematosus were potentially associated with an elevated risk of gastric cancer. Surprisingly, ulcerative colitis had a protective effect against gastric cancer, especially among East Asian countries. Regarding sex analysis, male and female patients were similarly susceptible to autoimmunity-induced gastric carcinogenesis. As for geographical differences, patients with autoimmune diseases from Nordic countries were most likely to have an increased risk of gastric cancer, while autoimmune diseases seemed to have protective effects against gastric cancer among Japanese patients, especially those with rheumatoid arthritis.
METHODS: Literature retrieval was performed based on PubMed, Web of Science, and Embase from inception to January 2025. Cohort studies investigating the risk ratio (RR) or incidence of gastric cancer among patients with autoimmune disorders were eligible. Relative risk was the primary endpoint [RR with 95% confidence interval (CI)], while incidence was the secondary endpoint.
RESULTS: A total of 285 studies were included, containing 61 556 078 participants. Overall pooled RR was 1.158 (95% CI 1.098-1.222, P < 0.001). Patients with autoimmune gastritis (3.066, P < 0.001), systemic sclerosis (1.788, P = 0.010), type 1 diabetes (1.411, P < 0.001), sarcoidosis (1.388, P = 0.004), and psoriasis (1.194, P = 0.001) were strongly associated with a higher risk of gastric cancer. Meanwhile, patients with dermatomyositis (2.100, P = 0.034) and systemic lupus erythematosus (1.296, P = 0.038) were also associated with increased risk of gastric cancer, despite smaller effect sizes and higher P values. Subgroup analyses based on sex and geographical regions were also conducted.
CONCLUSION: Autoimmune diseases were associated with increased gastric cancer risk, especially autoimmune gastritis, systemic sclerosis, type 1 diabetes, sarcoidosis, and psoriasis. Patients with dermatomyositis and systemic lupus erythematosus were potentially associated with an elevated risk of gastric cancer. Surprisingly, ulcerative colitis had a protective effect against gastric cancer, especially among East Asian countries. Regarding sex analysis, male and female patients were similarly susceptible to autoimmunity-induced gastric carcinogenesis. As for geographical differences, patients with autoimmune diseases from Nordic countries were most likely to have an increased risk of gastric cancer, while autoimmune diseases seemed to have protective effects against gastric cancer among Japanese patients, especially those with rheumatoid arthritis.