Primary Immunodeficiencies Linked to Early-Onset GI Cancers

The study covered in this summary was published on medRxiv.org as a preprint and has not yet been peer reviewed.

Key Takeaways

Patients with primary immunodeficiencies, also known as inborn errors of immunity (IEIs), are at higher risk for early-onset gastrointestinal (GI) cancers.
These patients should be screened for GI cancers earlier than the general population.

Why This Matters

IEIs, which increase an individual’s susceptibility to infections, autoimmune diseases, and allergies, have not generally been considered a risk factor for GI cancers. No practice guidelines exist for screening these patients for cancer.
Given the current findings, the authors recommend updating guidelines to recognize IEIs as a risk factor for GI cancers and to screen this population earlier.

Study Design

The investigators reviewed 149 patients diagnosed with both an IEI and GI cancer pulled from 76 publications in the medical literature.

Key Results

Of the 149 patients, most had gastric cancer (n = 95) or colorectal cancer (n = 35).
The most frequently occurring IEI was common variable immune deficiency (n = 88).
The mean age at gastric cancer diagnosis was 46 years, and the mean age at colorectal cancer diagnosis was 33 years — both significantly earlier than the general population, according to SEER data.
Impaired humoral immunity and Epstein-Barr virus infection were frequently reported as factors in early-onset malignancy.

Limitations

No study limitations were reported.

Disclosures

The work was funded by the National Institutes of Health.
The investigators didn’t have any disclosures.

This is a summary of a preprint research study, “Immunogenetics of Gastrointestinal Cancers: A Systematic Review of Inborn Errors of Immunity in Humans,” led by Beishi Zheng of Columbia University, New York City. The study has not been peer reviewed. The full text can be found at medRxiv.org.

M. Alexander Otto is a physician assistant with a master’s degree in medical science. He is an award-winning medical journalist who worked for several major news outlets before joining Medscape and is an MIT Knight Science Journalism fellow. Email: [email protected].

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