Department of Internal Medicine, University of Manitoba, Winnipeg, Canada/Department of Community Health Sciences, University of Manitoba, Winnipeg, Canada
Department of Internal Medicine, University of Manitoba, Winnipeg, Canada.
Mult Scler. 2015 Mar;21(3):294-304. doi: 10.1177/1352458514564489. Epub 2014 Dec 22.
Studies of cancer incidence and prevalence in multiple sclerosis (MS) have produced conflicting results.
To estimate the incidence and prevalence of cancer in persons with MS and review the quality of included studies.
We searched the PUBMED, SCOPUS, Web of Knowledge, and EMBASE databases, conference proceedings, and reference lists of all articles retrieved. Abstracts were screened for relevance by two reviewers. Data from included articles were captured using a standardized form, and the abstraction was verified by a second reviewer. We assessed quality of the included studies. We quantitatively assessed studies using the I (2) statistic, and conducted meta-analyses for population-based studies.
We identified 38 studies. Estimates for incidence and prevalence varied substantially for most cancers. In population-based studies, cervical, breast, and digestive cancers had the highest incidence. The risk of meningiomas and urinary system cancers appeared higher than expected, while the risks of pancreatic, ovarian, prostate and testicular cancer were lower than expected.
The complexity of understanding cancer risk in MS is augmented by inconsistencies in study design, and the relative paucity of age, sex and ethnicity-specific risk estimates from which the strong impact of age on the incidence of cancers can be assessed.
多项多发性硬化症（MS）相关的癌症发病率和患病率研究结果相互矛盾。
评估 MS 患者的癌症发病率和患病率，并对纳入研究的质量进行综述。
我们检索了 PUBMED、SCOPUS、Web of Knowledge 和 EMBASE 数据库、会议记录以及检索到的所有文章的参考文献列表。两位评审员对摘要进行了相关性筛选。使用标准化表格捕获纳入文章的数据，并由第二位评审员验证提取内容。我们评估了纳入研究的质量。我们使用 I² 统计量对研究进行了定量评估，并对基于人群的研究进行了荟萃分析。
我们共识别出 38 项研究。大多数癌症的发病率和患病率估计值差异很大。在基于人群的研究中，宫颈癌、乳腺癌和消化系统癌症的发病率最高。脑膜瘤和泌尿系统癌症的风险似乎高于预期，而胰腺癌、卵巢癌、前列腺癌和睾丸癌的风险则低于预期。
由于研究设计的不一致性以及年龄、性别和种族特异性风险估计值相对较少，因此理解 MS 中癌症风险的复杂性增加了，而这些估计值可评估年龄对癌症发病率的强烈影响。
