Overall malignancy risk in patients with ankylosing spondylitis (AS), including digestive malignancies, multiple myelomas, and lymphomas, is higher as compared with the general population, according to research published in Scientific Reports.

In a systematic review and meta-analysis, researchers sought to clarify the inconsistent current information surrounding site-specific malignancy and AS. The comparative risk of specific malignancy development in AS as compared with the general population was then evaluated.

Researchers performed a literature search of 5 databases to locate studies eligible for meta-analysis. All articles underwent a preliminary screening focused on the study title and abstract, followed by a full text screening to confirm eligibility; after screening, 23 studies of different designs were deemed eligible.

High Yield Data Summary

  • AS patients should be monitored for early identification of digestive system cancers, multiple myelomas, and lymphomas.

Through the meta-analysis, the researchers determined that AS is associated with a 14% increase in overall malignancy risk (pooled relative risk [RR] 1.14, 95% confidence interval [CI] 1.03-1.25).

When compared with controls, AS patients are specifically  at an increased risk for digestive issues (pooled RR 1.20; 95% CI 1.11-1.57), multiple myelomas (pooled RR 1.92; 95% CI 1.37-3.69), and lymphomas (pooled RR 1.32; 95% CI 1.11-1.57).

Subgroup analyses indicated that patients with AS from Asia are at the highest risk for overall malignancy.

“Until now, the risk for malignancy associated with AS had not been fully clarified, with discrepancy in reported results,” researchers stated. “To our knowledge, this is the first systematic review and meta-analysis to asses the association between AS and malignancy.”

Summary and Clinical Applicability

Based on the performed analysis, Dr Deng and colleagues recommend that AS patients should be monitored for early identification of digestive system cancers, multiple myelomas, and lymphonas. They note that additional large-scale, longitudinal studies should be performed to draw firm conclusions linking AS and its associated risks.

Limitations and Disclosures  

  • Although studies included in the meta-anylsis focused on malignancy risk in AS patients, potential bias of the results exists due to the varied design and covariate adjustments in the studies analyzed.
  • Subgroup analysis could not be performed in cases where the reported cancers were not divided or described in detail, limiting the researcher’s ability to link AS as a risk factor for certain cancers.
  • Eligibility screenings did not consider AS management strategies employed; a link between effect of treatment and malignancy risk cannot be made.
  • Due to institutional limitations, the researchers were unable to include Google Scholar studies within their search, which they note is “contrary to standard practice in systematic reviews.”

This study was supported with funding from the National Natural Science Foundation of China Grants (81202360, 81471614, and 81302591).

The authors declare no competing financial interests.

Reference

Deng C, Li W, Fei Y, et al. Risk of malignancy in ankylosing spondylitis: a systematic review and meta-analysis. Sci Rep. 2016;6:32063. doi: 10.1038/srep32063

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