Is atopy a protective or a risk factor for cancer? A review of epidemiological studies

Objective: There is an ongoing debate whether there is a link between a history of atopy and cancer risk. The purpose of this paper is to review the published epidemiological studies on the association between atopy and the risk of cancers. Methods: Through an electronic search (January 1986-April 2004) with an additional review of cited references, we identified studies with quantitative data on the relation of atopy (irrespective of its definition or subtype) to cancer (different cancer sites). Results: The protective effect of atopy in colorectal cancer has been observed consistently in the case-control studies, but not in cohort studies. A consistent inverse association between self-reported atopy and glioma risk has been shown, but there is absence of such an association for meningioma. In most studies, the risk of leukaemia, in particular childhood leukaemia, tends to be lower among people with a history of atopy. Studies, which looked at, the association between atopic diseases and risk of cancers of pancreatic, breast, lymphoma showed varying outcomes. Most studies on the atopy-pancreatic cancer relation suggested an inverse association. For lymphoma, most studies have shown no substantial association. Overall evidence indicates an increased risk of lung cancer among persons with a history of asthma. Conclusion: Despite the mixed results, the emerging picture from most of the currently available epidemiological data indicate that atopic disease is associated with a reduced risk for cancer. Further research should focus on a more carefully defined 'atopy' status and manifestation of different atopic diseases, to advance our understanding of the role that allergies might play in the risk of developing cancer.