在80多种不同的自身免疫性疾病中，银屑病（PsO）、类风湿性关节炎（RA）和强直性脊柱炎（AS）是常见的代表。先前的研究表明其与癌症风险存在潜在联系，但往往受到统计功效较低的影响。因此，我们的目的是综合证据并量化与不同女性特定癌症部位的关联。系统评价是根据 PRISMA 指南进行的。为 PubMed、Web of Science、Cochrane Library 和 Embase 数据库开发了搜索字符串。结果由两名研究人员独立筛选，并使用 ROBINS-E 工具评估偏倚风险。使用逆方差加权随机效应模型进行荟萃分析。通过计算 Cochran 的 Q、τ2 和 Higgins 的 I2 统计量来量化研究间的统计异质性。以荟萃回归、离群值、影响力和亚组分析的形式，在强化偏倚评估中分析和调整异质性来源。使用了一系列方法来测试和调整发表偏倚。在最初通过搜索策略识别的 10,096 条记录中，有 45 条记录包含在荟萃分析中。 RA 与乳腺癌和子宫癌的发生呈负相关，而 PsO 与较高的乳腺癌风险相关。离群值调整后的估计证实了这些发现。偏差评估揭示了地理区域的差异，特别是在 RA 患者中，亚洲研究中的估计值较高。另一项分析显示银屑病关节炎与乳腺癌之间没有关联。RA 似乎可以降低患乳腺癌和子宫癌的风险，而 PsO 似乎会增加患乳腺癌的风险。需要进一步的大型研究来调查潜在的治疗效果和详细的生物学机制。版权所有 © 2024 作者。由爱思唯尔有限公司出版。保留所有权利。

Among the over 80 different autoimmune diseases, psoriasis (PsO), rheumatoid arthritis (RA), and ankylosing spondylitis (AS) are common representatives. Previous studies indicated a potential link with cancer risk, but suffered often from low statistical power. Thus, we aimed to synthesize the evidence and quantify the association to different female-specific cancer sites.The systematic review was performed according to PRISMA guidelines. A search string was developed for the databases PubMed, Web of Science, Cochrane Library and Embase. Results were screened independently by two investigators and the risk of bias was assessed using the ROBINS-E tool. Meta-analyses were performed using inverse variance weighted random-effects models. Statistical between-study heterogeneity was quantified by calculating Cochran's Q, τ2, and Higgins' I2 statistics. Sources of heterogeneity were analyzed and adjusted for within an intensive bias assessment in the form of meta-regression, outlier, influential, and subgroup analyses. A range of methods were used to test and adjust for publication bias.Of 10,096 records that were originally identified by the search strategy, 45 were included in the meta-analyses. RA was inversely associated with both breast and uterine cancer occurrence, while PsO was associated with a higher breast cancer risk. Outlier-adjusted estimates confirmed these findings. Bias assessment revealed differences in geographic regions, particularly in RA patients, with higher estimates among Asian studies. An additional analysis revealed no association between psoriatic arthritis and breast cancer.RA seems to reduce the risk of breast and uterine cancers, while PsO appears to increase breast cancer risk. Further large studies are required to investigate potential therapy-effects and detailed biological mechanisms.Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.