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IgA Deficiency and Risk of Cancer: A Population-Based Matched Cohort Study

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Journal of Clinical Immunology Aims and scope Submit manuscript

Abstract

Purpose

To investigate the risk of cancer in individuals with IgA deficiency compared with the general population.

Methods

Prospective nationwide population-based cohort study. We identified 2320 individuals with IgA deficiency (IgA levels < 0.07 g/L) diagnosed between 1980 and 2010 in six Swedish university hospitals. Individuals with IgA deficiency were then matched on age, sex, place of residence, and year of diagnosis with up to 10 general population controls (n = 23,130). Through linkage with the Swedish Cancer Register we calculated conditional hazard ratios (HRs) for cancer diagnosed after IgA deficiency diagnosis in patients without a previous cancer diagnosis.

Results

During follow-up, 125 individuals with IgA deficiency (61/10,000 person-years) and 984 controls (47/10,000 person-years) developed cancer (HR 1.31; 95%CI = 1.09–1.58). In cause-specific analyses, we found an increased risk of any gastrointestinal cancer (HR = 1.64; 95%CI = 1.07–2.50), but not for lymphoproliferative malignancy (HR 1.68; 95%CI = 0.89–3.19). Relative risk estimates for overall cancer were very high in the first year of follow-up (overall: HR = 2.80; 95%CI = 1.74–4.49), but failed to reach statistical significance thereafter. IgA deficiency diagnosed in childhood (n = 487) was not associated with overall cancer (HR = 3.26; 0.88–12.03).

Conclusions

Individuals with IgA deficiency are at a moderately increased risk of cancer, with excess risks of gastrointestinal cancer. This excess risk is highest just after diagnosis suggesting a degree of surveillance bias. Children with IgA deficiency were at no increased risk of cancer but the statistical power was limited in subanalyses.

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Abbreviations

CD:

Celiac disease

GI:

Gastrointestinal

HR:

Hazard ratio

LPM:

Lymphoproliferative malignancy

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Conflict of Interest

The authors (JFL, MN, LH, WY) declare that they have no conflicts of interest relevant to the contents of this manuscript.

Details of Contributors

Dr Ludvigsson and Dr Neovius had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.

Study concept and design: Ludvigsson

Acquisition of data: Hammarström

Drafting of the manuscript: Ludvigsson, Neovius, Ye, Hammarström

Critical revision of the manuscript for important intellectual content: Hammarström, Ludvigsson, Neovius, Ye

Statistical analysis: Ludvigsson, Neovius

Obtained funding: Hammarström

Study supervision: Ludvigsson, Hammarström

Ethical Approval

This project (2011/69-31/3) was approved by the Regional Ethical Review Board in Stockholm on Feb 23, 2011. This was a register-based study and therefore all data were anonymised prior to analysis, and we were not allowed to contact the patients.

Funding

JFL was supported by grants from the Swedish Society of Medicine, and the Swedish Research Council; MN: None; LH: Swedish Research Council.

Statement of Independence of Researchers from Funders

No person representing the funding sources read or commented on any version of the manuscript.

Author information

Authors and Affiliations

  1. Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden

    Jonas F. Ludvigsson & Weimin Ye

  2. Department of Paediatrics, Örebro University Hospital, Örebro University, Örebro, Sweden

    Jonas F. Ludvigsson

  3. Clinical Epidemiology Unit, Department of Medicine, Karolinska Institutet, Stockholm, Sweden

    Martin Neovius

  4. Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden

    Lennart Hammarström

Authors
  1. Jonas F. Ludvigsson
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  2. Martin Neovius
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  3. Weimin Ye
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  4. Lennart Hammarström
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Corresponding author

Correspondence to Jonas F. Ludvigsson.

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Ludvigsson, J.F., Neovius, M., Ye, W. et al. IgA Deficiency and Risk of Cancer: A Population-Based Matched Cohort Study. J Clin Immunol 35, 182–188 (2015). https://doi.org/10.1007/s10875-014-0124-2

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  • DOI: https://doi.org/10.1007/s10875-014-0124-2

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