Cancer Risk in Autoimmune and Immune-Mediated Diseases: A Narrative Review for Practising Clinicians.

Area of Science:

• Immunology
• Oncology
• Rheumatology

Background:

• Autoimmune and immune-mediated disorders are linked to higher malignancy risk.
• Factors include chronic inflammation, immune dysregulation, and treatments.
• Understanding specific cancer risks is vital for clinical vigilance and screening.

Purpose of the Study:

• To synthesize evidence on autoimmune diseases and cancer risk.
• To provide practical implications for clinicians.
• To identify high-risk phenotypes and screening strategies.

Main Methods:

• Analysis of recent cohort studies, meta-analyses, and expert consensus.
• Review of various autoimmune conditions including idiopathic inflammatory myopathies, Sjögren's syndrome, systemic sclerosis, lupus, rheumatoid arthritis, and others.
• Focus on epidemiology, pathogenic mechanisms, risk stratification, and screening.

Main Results:

• Cancer risk magnitude and patterns vary significantly among autoimmune diseases.
• Conditions like dermatomyositis, systemic sclerosis, and Sjögren's syndrome show established risks for hematological and solid tumors.
• Clinical/serological features aid risk stratification; early disease onset may indicate higher vulnerability.

Conclusions:

• Cancer risk assessment in autoimmune diseases requires an individualized approach.
• Awareness of disease-specific factors and warning signs is key for early malignancy recognition.
• Informed screening decisions are essential in clinical practice.