All-cause Mortality in Danish Multiple Sclerosis Patients Following a New Diagnosis of Cancer: A National Registry Analysis
Abstract/Contents
- Abstract
- Multiple sclerosis (MS), a chronic, autoimmune neurological disease, typically has a prolonged natural course, conferring only a modest decline in life expectancy in treated patients. As such, MS patients remain susceptible to death from other diseases, including cancer. Although MS patients appear to be at a slightly decreased risk of being diagnosed with cancer, the prognosis of MS patients following a new cancer diagnosis has not been fully explored. Immunological mechanisms, interference with adequate treatment, co-morbidities, and diagnostic delays could all confer a worse prognosis compared to cancer patients without MS. In this population-based study using linked administrative datasets from Denmark, we compared the all-cause mortality of MS patients with a set of matched population controls, following a first-time diagnosis of cancer. We identified 2,178 patients diagnosed with MS between 1975-2015 in the Danish National Patient Registry and matched to 18,589 non-MS patients (up to 10 matches per MS case) on age, sex, year of cancer diagnosis, type of cancer, and cancer stage. All-cause mortality in a Cox regression model adjusting for all of the above factors demonstrated increased mortality of MS patients compared to the matched controls (HR 1.38, 95% CI 1.28-1.47). When stratifying the Cox regression models according to type of cancer, the greatest mortality differences were observed for melanoma and other immunologic- or infectious-related cancers. No mortality difference was observed for hematological cancers or for lung cancer. We conclude that MS patients have increased mortality following cancer diagnosis compared to non-MS patients. We hypothesize that immunological mechanisms that promote tumor progression or interfere with immune-based treatments may contribute to poorer cancer prognosis in MS patients, although we cannot exclude that increased deaths associated with MS may have impacted the observed survival differences.
Description
| Type of resource | text |
|---|---|
| Publication date | March 15, 2024; June 5, 2019 |
Creators/Contributors
| Author | Fleming, Nathaniel |
https://orcid.org/0000-0001-8130-9189
(unverified)
|
|---|---|---|
| Thesis advisor | Henderson, Victor | |
| Thesis advisor | Tamang, Suzanne |
Subjects
| Subject | Multiple sclerosis > Epidemiology |
|---|---|
| Subject | Cancer > Epidemiology |
| Genre | Text |
| Genre | Thesis |
Bibliographic information
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- This work is licensed under a Creative Commons Attribution 4.0 International license (CC BY).
Preferred citation
- Preferred citation
- Fleming, N. (2024). All-cause Mortality in Danish Multiple Sclerosis Patients Following a New Diagnosis of Cancer: A National Registry Analysis. Stanford Digital Repository. Available at https://purl.stanford.edu/np423kq5276. https://doi.org/10.25740/np423kq5276.
Collection
Epidemiology & Clinical Research Masters Theses
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- nhfleming@alumni.stanford.edu
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