Differential impact of immune-mediated inflammatory diseases before versus after cancer on patient survival: a nationwide cohort study
Authors' conclusion
Our study highlights the differential impacts of IMIDs diagnosed before and after cancer onset on survival outcomes. While pre-existing IMIDs appear to exacerbate mortality risk, newly diagnosed IMIDs post-cancer may confer a survival advantage.
Study context
- Population
- UK Biobank adults aged 37–73 years with cancer (mean [SD] age 60.2 [6.9] years; 51% female); follow-up until 31 September 2021
- Participants
- 93,884 cancer participants
- Exposure
- Immune-mediated inflammatory diseases (IMIDs) diagnosed before cancer or after cancer vs no IMIDs in cancer patients
- Outcome
- All-cause mortality and cause-specific mortality
Methodological detailsnationwide, UK Biobank
- Nationwide
- UK Biobank
Main finding
As reported in the abstract
All-cause mortality
Each group vs WITHOUT IMIDsHazard ratio (95% CI)
IMIDs BEFORE CANCER
1.78(1.71–1.86)
IMIDs AFTER CANCER
0.79(0.75–0.83)
Observational data: associations, not effects.
Further findings
| Outcome | HR (95% CI) | |
|---|---|---|
| Cancer-specific mortalityIMIDs BEFORE CANCERvs WITHOUT IMIDs | 1.62 (1.55–1.71) | |
| Cancer-specific mortalityIMIDs AFTER CANCERvs WITHOUT IMIDs | 0.69 (0.66–0.73) | |
| 0.512Hazard ratio (log scale) |
Subgroup (timing of ICI introduction) and propensity score matching analyses
- Findings remained consistent
Individual IMIDs and all-cause mortality across cancer types
- IMIDs diagnosed after cancer showed diminished or reversed effects on mortality compared with those diagnosed prior to cancer
Original publication
Differential impact of immune-mediated inflammatory diseases before versus after cancer on patient survival: a nationwide cohort study. Rheumatology (Oxford). Published 8 May 2025. doi:10.
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