Additive interaction and network analysis of co-occurring allergic diseases in relation to cancer risk

Cancer risk with multiple co-occurring allergic diseases remains unclear, and research on their additive or synergistic interactions is limited.

A nationally representative population from the US National Health Interview Survey was enrolled. Five specific allergic diseases, including asthma, allergic rhinitis (AR), food allergy (FA), eczema, and other allergy (OA), were determined. Overall cancer and 30 kinds of site-specific cancers were determined. We evaluated additive interaction effects between two allergic diseases on cancer risk; relative excess risk due to interaction (RERI) and attributable proportion of joint effect due to interaction (AP) were calculated. Network analyses were further performed.

Totally, 34,403 participants were enrolled. Allergic group showed a significantly increased risk of overall cancer, with an OR of 1.37 (1.23-1.52). Three co-occurrence patterns were significantly associated with an increased risk of overall cancer: AR + FA (OR: 2.39, 1.40-4.08), eczema + OA (OR: 2.25, 1.16-4.36), and asthma + AR (OR: 1.42, 1.02-1.99). A significant AP of 42.3% (4.0-80.6%) was observed for the combination of AR and FA. Network analyses showed that, compared with the non-cancer group, all of the above three co-occurrence that showed significant associations with overall cancer showed increased correlation coefficients in the overall cancer group. In the site-specific cancer analyses, overall allergy was associated with increased risk of seven kinds of cancer, such as leukemia.

We identified several patterns of co-occurrence of allergic diseases with significantly increased risk of overall cancer and site-specific cancers. Precision primary prevention of cancer is necessary for individuals with co-occurring allergic conditions.