Cancer risk in individuals with autism spectrum disorder
Menée à partir de données portant sur 2,3 millions de personnes nées entre 1987 et 2013 en Suède, cette étude analyse l'association entre des troubles du spectre autistique et le risque de cancer
Background: Whether individuals with autism spectrum disorders (ASD) have a higher-than-expected risk of cancer remains unknown. Patients and methods: We performed a population-based cohort study including 2.3 million individuals live-born to mothers from Nordic countries during 1987-2013 in Sweden with follow-up through 2016 (up to age 30). Individuals with ASD were ascertained through the Swedish National Patient Register. We estimated the relative risk of cancer in relation to ASD by odds ratios (ORs) and associated 95% confidence intervals (CIs) derived from logistic regression, after detailed adjustment for potential confounders. We also performed a sibling comparison to address familial confounding and a genetic correlation analysis using GWAS summary statistics to address confounding due to potential polygenetic pleiotropy between ASD and cancer. Results: We observed an overall increased risk of any cancer among individuals with ASD (OR 1.3, 95% CI 1.2-1.5), compared with individuals without ASD. The association for any cancer was primarily noted for narrowly defined autistic disorder (OR 1.7, 95% CI 1.3-2.1) and ASD with comorbid birth defects (OR 2.1, 95% CI 1.5-2.9) or both birth defects and intellectual disability (OR 4.8, 95% CI 3.4-6.6). An association was also suggested for ASD with comorbid intellectual disability (OR 1.4; 95% CI 0.9-2.1), but not statistically significant. ASD alone (i.e., without comorbid intellectual disability or birth defects) was not associated with an increased risk of any cancer (OR 1.0, 95% CI 0.8-1.2). Sibling comparison and genetic correlation analysis showed little evidence for familial confounding or confounding due to polygenetic pleiotropy between ASD and cancer. Conclusions: ASD per se is not associated with an increased risk for cancer in early life. The increased cancer risk among individuals with ASD is likely mainly attributable to co-occurring intellectual disability and/or birth defects in ASD.