A new study indicates that people who develop colon cancer are more likely to die in the first year, from this cancer or other causes, if they also have multiple sclerosis (MS). MS disability seems to contribute to this association.
“These results warrant further research to determine which factors may lead to shorter survival periods,” Ruth Ann Marrie, MD, PhD, professor at the University of Manitoba in Winnipeg, Canada and co-author of the study, told a press release . release.
“Are people with MS less likely to receive cancer treatment? Or are they less able to tolerate the effects of chemotherapy? Are there specific factors for MS? What is the degree of accommodation in the cancer care system for people with disabilities? These are some of the many issues that need to be investigated, ”Marrie said.
The study, “Colorectal cancer survival in multiple sclerosis: a coincident cohort study“, Was published in Neurology.
Cancer is one of the leading causes of death among people with MS, but the interaction between the two diseases is little known.
A separate study by Marrie and other scientists, published earlier this year, suggested that MS did not increase the risk of cancer-related deaths among breast cancer patients. However, breast cancer patients with MS had a significantly higher risk of death from any cause a decade after cancer diagnosis.
Now, the researchers set out to assess how MS affects the survival outcomes of people with colorectal cancer, which includes any cancer that affects the colon and rectum.
Analyzing Canadian databases, researchers identified 338 people with MS who were diagnosed with colorectal cancer in the provinces of Manitoba and Ontario from 1994 to 2016. Their median age was 64.6 years and approximately two-thirds of patients they were women.
For comparison, the researchers also identified 1,352 people with colon cancer who did not have MS. The two groups were related by age, sex, year in which the cancer was diagnosed, and region of residence. The stage of colon cancer at the time of diagnosis did not differ significantly between the groups with MS and not with MS.
The results showed that MS was associated with an increased risk of death from any cause. This association was strongest, in a statistical sense, six months after the diagnosis of cancer, when patients with MS had a 45% higher risk of death from all causes. The association was less noticeable, but still significant, in one year, and lost its statistical importance at later times.
In particular, MS was also associated with an increased risk of cancer death. Specifically, at six months after cancer diagnosis, MS patients were 29% more likely to die of cancer.
“We found that early survival was lower in people with MS than without MS after the diagnosis of colorectal cancer,” the researchers concluded. “This has potential implications for clinical decision making and further study is needed to determine what factors underlie these worst outcomes.”
It should be noted that the association between MS and early mortality decreased when the analysis took into account disability. Disability in MS patients is often associated with frailty and the results suggest that it may prevent patients from receiving appropriate cancer treatments.
“Understanding more about the factors involved in cancer treatment in people with MS and their outcomes will be helpful for people with MS and their doctors, as they balance the benefits of cancer treatment with the possible adverse effects and have taking into account life expectancy and quality of life “. Marrie said.