Sjögren’s disease may increase risk of certain digestive cancers: Korean study
Danger particularly high for women and older patients
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Adults with primary Sjögren’s disease are at a higher risk of developing colorectal and pancreatic cancers — especially women and older patients — according to a Korean study.
“Further research should explore the underlying mechanisms and the impact of [primary Sjögren’s disease] duration and severity on cancer risk,” researchers wrote.
The study, “Risk of gastrointestinal cancers in patients with primary Sjögren’s syndrome in Korea: a nationwide retrospective cohort study,” was published in Arthritis Research & Therapy.
Disease can also affect the gastrointestinal tract
Sjögren’s is an autoimmune disease in which the immune system mistakenly attacks the body’s moisture-producing glands, leading to hallmark symptoms such as dry eyes and dry mouth. The disease can also affect multiple other tissues and organs, including those in the gastrointestinal tract.
In primary Sjögren’s, or simply Sjögren’s, the disease occurs on its own, as opposed to secondary Sjögren’s, which develops as a complication of other underlying conditions.
People with Sjögren’s have a higher risk of non-Hodgkin’s lymphoma, a type of blood cancer. However, there is limited robust evidence on whether Sjögren’s increases the risk of gastrointestinal cancers.
In this study, a team of researchers in Japan set out to determine the risk of gastrointestinal cancers in people with Sjögren’s, while adjusting analyses for lifestyle factors, which are a key contributor to these types of cancers.
The researchers drew on data from the National Health Insurance Service-National Sample Cohort, a large Korean health database, and identified 850 people with Sjögren’s and 319,232 people without the disease.
Sjögren’s patients at much higher risk of colorectal, pancreatic cancers
Sjögren’s patients were significantly older (57.37 vs. 55.31 years) and more often women (64.47% vs. 42.79%) than the non-Sjögren’s group. People with Sjögren’s were also significantly less likely to have a history of smoking (17.87% vs. 28.95%) and to drink alcohol two or more days per week (6.71% vs. 10.42%).
The team compared the frequency of all gastrointestinal cancers and, individually, those affecting the stomach, colon, and rectum (parts of the large intestine), as well as the liver, gallbladder, and pancreas. Statistical analyses were adjusted for potential influencing factors, including age, sex, BMI, smoking status, alcohol consumption, and physical activity.
Results showed that Sjögren’s patients had numerically higher frequencies of gastrointestinal cancers than people without the disease. While the disease was linked to a 24% higher risk of these cancers, this result did not reach statistical significance, meaning it could be due to random chance.
However, when looking at digestive cancers by location, adults with Sjögren’s had a significantly higher risk, by about 60%, of developing colorectal cancer, while their risk of pancreatic cancer was increased by twofold.
These findings underscore the importance of monitoring gastrointestinal cancer risk in patients with [primary Sjögren’s disease], particularly among older adults and females.
Sex also influenced these associations. Women, but not men, with Sjögren’s had a significantly higher risk of all gastrointestinal cancers (by 56%), colorectal cancer (by nearly twofold), and pancreatic cancer (by threefold) than those without the disease.
In terms of age, only Sjögren’s patients aged 60 years and older, and not younger patients, showed significantly increased risks relative to their non-Sjögren’s counterparts.
Specifically, older patients had a 43% higher chance of all gastrointestinal cancers, a 76% increased risk of pancreatic cancer, a 50% higher risk of stomach cancer, and a 34% increased chance of colorectal cancer than older people without Sjögren’s.
“These findings underscore the importance of monitoring gastrointestinal cancer risk in patients with [primary Sjögren’s disease], particularly among older adults and females,” the researchers wrote. “Further studies in other populations are needed to verify these findings.”
They added that more research is needed to understand why this happens and whether disease duration or severity further changes the risk of digestive cancers.
