Association between multiple sclerosis and cancer risk: An extensive review/meta and Mendelian randomization analyses

• Published in: Multiple sclerosis and related disorders 2023-08, Vol.76, p.104798-104798, Article 104798
• Main Authors: Liu, Qiangzhao, Kang, Jian, Yin, Yongsheng, zhang, jinling, Lian, Qiong, Zhou, Fenghai
• Format: Article
• Language: English
• Subjects: Brain Neoplasms - complications; Breast Neoplasms - complications; Cancer incidence; Female; Humans; Lung Neoplasms - complications; Mendelian Randomization Analysis; Meta-analysis; Multiple sclerosis; Multiple Sclerosis - complications; Multiple Sclerosis - epidemiology; Multiple Sclerosis - genetics; Ovarian Neoplasms; Polymorphism, Single Nucleotide
• ISSN: 2211-0348; 2211-0356
• DOI: 10.1016/j.msard.2023.104798

•Based on our knowledge of published literature, this is the first meta-analysis to extensively study available data for a potential causal link between MS and cancer incidence.•Using meta-analysis, we demonstrated that MS patients experienced an enhanced risk of pancreatic and ovarian cancers, as well as a diminished risk of breast and brain cancers.•However, based on our MR analysis, the connection between MS and breast cancer incidence was inverse, and enhanced lung cancer co-occurrence was present among MS patients, which may be due to the characteristics of our traditional observational study. Thus, caution must be practice while interpreting the data and presenting causal interactions. Observational investigations examining cancer risk among multiple sclerosis (MS) patients have produced contradictory findings. Herein, we performed an extensive review and meta-analysis to evaluate the correlation and causation between MS and cancer incidence. We systematically screened for published articles examining cancer incidences among MS patients within the Cochrane Library, PubMed, and Embase databases. Next, we employed STATA v.16.0 for data analysis. Following meta-analysis, we performed a two-sample Mendelian randomization (MR) analysis to uncover the underlying mechanism behind the MS-mediated regulation of certain cancers. Overall, we selected 18 articles encompassing 14 individual cancers incidences and a total of 368,952 patients for meta-analysis. Based on our analysis, there was reduced pancreatic (ES = 0.68; 95% CI: 0.49–0.93; I 2 = 0%) and ovarian cancer (ES = 0.65; 95% CI: 0.53–0.80; I 2 = 86.7%) co-occurrences among MS patients. Meanwhile, the incidences of breast (ES = 1.10; 95% CI: 1.01–1.21; I 2 = 60.9%) and brain cancers (ES = 1.94; 95% CI: 1.12–3.37; I 2 = 56.1%) were elevated among the same population. However, MR analysis revealed the opposite relation between MS and breast cancer risk (OR = 0.94392; 95% CI: 0.91011–0.97900, P = 0.002). Moreover, it revealed strong incidence of lung cancer (OR = 1.0004; 95% CI: 1.0001–1.0083, P = 0.001) among MS patients, as evidenced by the inverse variance weighting estimator. Lastly, MR found that other forms of cancers were not significantly related to MS. Using meta-analysis, we demonstrated that MS patients exhibited enhanced pancreatic and ovarian cancer risk, and diminished breast and brain cancer risk. However, using MR analysis, we discovered an inverse relation between MS and breast cancer risk,