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Original Research: Diffuse Lung Disease |

Sarcoidosis and Cancer RiskSarcoidosis and Cancer Risk: Systematic Review and Meta-analysis of Observational Studies

Martina Bonifazi, MD; Francesca Bravi, PhD; Stefano Gasparini, MD, FCCP; Carlo La Vecchia, MD; Armando Gabrielli, MD; Athol U. Wells, MD; Elisabetta A. Renzoni, MD
Author and Funding Information

From the Department of Epidemiology (Dr Bonifazi), Istituto di Ricerche Farmacologiche Mario Negri-Istituto di Ricovero e Cura a carattere Scientifico (IRCCS), Milan, Italy; Department of Clinical Sciences and Community Health (Drs Bravi and La Vecchia), Università Degli Studi di Milano, Milan, Italy; Department of Biomedical Sciences and Public Health (Dr Gasparini) and Department of Clinical and Molecular Sciences (Dr Gabrielli), Università Politecnica delle Marche, Ancona, Italy; and Interstitial Lung Disease Unit (Drs Wells and Renzoni), Royal Brompton Hospital, Royal Brompton & Harefield NHS Foundation Trust, London, England.

CORRESPONDENCE TO: Martina Bonifazi, MD, Department of Epidemiology, Istituto di Ricerche Farmacologiche Mario Negri-IRCCS, Via La Masa 19, 20256 Milan, Italy; e-mail: martina.bonifazi@marionegri.it


FUNDING/SUPPORT: This work has been partly supported by the “Fondazione di Medicina Molecolare e Terapia Cellulare” (Università Politecnica delle Marche, Ancona), the Italian Association for Cancer Research [Grant 10068 to Istituto di Ricerche Farmacologiche Mario Negri-IRCCS], and by the NIHR Respiratory Disease Biomedical Research Unit at Royal Brompton & Harefield NHS Foundation Trust and Imperial College London.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.


Chest. 2015;147(3):778-791. doi:10.1378/chest.14-1475
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BACKGROUND:  An increased cancer risk in patients with sarcoidosis has been suggested, although results are conflicting in a number of case-control and cohort studies. We conducted a systematic review of all available data and performed a meta-analysis to better define and quantify the association between sarcoidosis and cancer.

METHODS:  We searched Medline and Embase for all original articles on cancer and sarcoidosis published up to January 2013. Two independent authors reviewed all titles/abstracts to identify studies according to predefined selection criteria. We derived summary estimates using a random-effects model and reported them as relative risk (RR). Publication bias was evaluated using a funnel plot and was quantified by the Egger test.

RESULTS:  Sixteen original studies, involving > 25,000 patients, were included in the present review. The summary RR to develop all invasive cancers was 1.19 (95% CI, 1.07-1.32). The results for selected cancer sites indicated a significantly increased risk of skin (RR, 2.00; 95% CI, 1.69-2.36), hematopoietic (RR, 1.92; 95% CI, 1.41-2.62), upper digestive tract (RR, 1.73; 95% CI, 1.07-2.79), kidney (RR, 1.55; 95% CI, 1.21-1.99), liver (RR, 1.79; 95% CI, 1.03-3.11), and colorectal cancers (RR, 1.33; 95% CI, 1.07-1.67). There was no evidence of publication bias for all cancers (P = .9), nor for any specific cancer site.

CONCLUSIONS:  The present meta-analysis suggests a significant, though moderate, association between sarcoidosis and malignancy.

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