New Findings Show Reduced Cancer Screening Among People with MS
April 29, 2022
A study of millions of people diagnosed with cancer in Ontario shows that, in people with MS, breast cancer was less often detected through routine screening than in people without MS and that higher disability levels appeared to be a factor in reduced cancer screening. A similar association was found with colon cancer, but was not significant. Further research may help determine why some people with MS might not be following recommendations for preventive care. Improving access to preventive care would ensure better outcomes for people with MS who get cancer.
- Multiple sclerosis involves an abnormal immune response that damages the brain and spinal cord (central nervous system). Since some emerging cancers can be eliminated by the immune system, there is a chance that people with MS could have an increased risk for cancer. However, this team previously reported finding no increased risk in breast and colorectal cancer among people with MS.
- This team (Queen’s University, Kingston, Ontario, University of Manitoba, Winnipeg, and others) looked at data from the Ontario Cancer Registry and other data comprising 14.8 million people who had been diagnosed with cancer. They identified 351 women with breast cancer and MS and compared them to 1,404 women with breast cancer and no MS. They also identified 54 people with colorectal cancer and MS who they compared to 216 people with colorectal cancer and no MS.
- The results showed that the odds of breast cancer being detected through a routine screening was 32% lower in women with MS. Although not statistically significant, there was a lower rate of screening for colon cancer among people with MS. Of the cases of colorectal cancer detected in people with MS, however, more were detected at stage 1, an early stage that more successfully treated than later stages. The authors note that this earlier detection may be related to colorectal cancer being identified during investigations of the bowel symptoms that can occur in people with MS.
- Reductions in cancer screening appeared somewhat related to higher levels of disability in 21% of the people with MS and breast cancer and 33% of the people with MS.
- Drs. Jennifer Yang and Jennifer Graves (University of California, Sand Diego) commented in an accompanying editorial that, although the findings from Canada may not be applicable to countries with different healthcare systems (like the United States), they do indicate a need for increased effort to manage preventive care in people with MS. Further research into why people with MS may not be following recommendations, and whether disability plays a role in creating barriers to preventive care, is critical to improving outcomes in people with MS and cancer.
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Multiple Sclerosis and the Cancer Diagnosis: Diagnostic Route, Cancer Stage, and the Diagnostic Interval in Breast and Colorectal Cancer
by Patti A Groome, PhD. Colleen Webber, PhD, Colleen J. Maxwell, PhD, Chad McClintock, MSc, Dallas Seitz, MD, PhD, Alyson Mahar, PhD, and Ruth Ann Marrie, MD, PhD, is published in Neurology
(published online April 27, 2022).