Autoimmune systemic diseases and malignancy: pathogenetic intersections, epidemiological patterns, and clinical approaches to cancer risk stratification (literature review)
Yehudina Ye.D.1, Trypilka S.А.2
Summary. Autoimmune diseases (AIDs) comprise a heterogeneous group of chronic immune-mediated inflammatory conditions characterized by loss of immune tolerance and persistent immune activation. Over recent decades, increasing evidence has highlighted a complex and bidirectional relationship between autoimmunity and malignancy. Several autoimmune systemic diseases, including dermatomyositis, Sjögren’s syndrome, and systemic sclerosis, are consistently associated with an increased risk of specific cancers, particularly lymphomas, lung cancer, and selected gynaecological malignancies. The mechanisms underlying this association are multifactorial and include chronic inflammation, oxidative stress, genomic instability, impaired tumour immune surveillance, and paraneoplastic immune responses triggered by tumour-associated antigens. In addition, immunosuppressive and targeted therapies may further modulate cancer susceptibility, although disentangling treatment-related risk from disease-related risk remains challenging. This narrative review summarizes current evidence on the epidemiology, pathophysiological mechanisms, and cancer patterns observed across major autoimmune systemic diseases. Particular emphasis is placed on temporal relationships, disease- and antibody-specific risk profiles, and the role of serological markers in cancer risk stratification. Furthermore, contemporary approaches to tailored malignancy screening are discussed. Overall, the data support an individualized, risk-adapted strategy to cancer surveillance in patients with AIDs, aiming to facilitate early detection and improve long-term clinical outcomes.
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