Timing of IMID Diagnosis Influences Cancer Survival Outcomes, Study Finds
A nationwide cohort study using UK Biobank data has shown that the timing of immune-mediated inflammatory disease (IMID) diagnosis relative to cancer onset significantly influences survival outcomes. The findings offer important considerations for clinicians managing patients with both cancer and IMIDs.
Among 93,884 patients with cancer (mean age 60.2 years; 51% female), those with IMIDs diagnosed before cancer had a higher risk of all-cause mortality (HR 1.78) and cancer-specific mortality (HR 1.62) compared to cancer patients without IMIDs.
In contrast, patients with IMIDs diagnosed after cancer had lower risks of both all-cause (HR 0.79) and cancer-specific mortality (HR 0.69). These associations held after adjusting for confounders, including immune checkpoint inhibitor use and propensity score matching.
“Our study highlights the differential impacts of IMIDs diagnosed before and after cancer onset on survival outcomes,” the authors stated. “While pre-existing IMIDs appear to exacerbate mortality risk, newly diagnosed IMIDs post-cancer may confer a survival advantage.”
Subgroup analyses further confirmed the consistency of these findings across cancer types and individual IMID categories. Mapping of IMID-cancer combinations demonstrated that the negative survival impact of pre-existing IMIDs was not uniformly mirrored when the same IMID was diagnosed after cancer, suggesting a complex and potentially context-dependent relationship.
For rheumatologists and oncologists, these results underscore the importance of diagnostic timing in IMID management among patients with cancer. Recognizing whether an IMID predates or follows cancer diagnosis may guide clinical decisions regarding immunosuppression, surveillance, and therapy sequencing.
“Clinicians should consider the implications of IMIDs management in patients with cancer to optimize treatment and improve overall survival,” the authors concluded. The findings support a nuanced approach to IMID surveillance and intervention in the oncology setting.
Reference
Deng G, Guo Z, Le J, et al. Differential impact of immune-mediated inflammatory diseases before versus after cancer on patient survival: a nationwide cohort study. Rheumatology (Oxford). 2025;64(9):4976-4984. doi:10.1093/rheumatology/keaf213
