Urologic Cancer in Patients with Ankylosing Spondylitis: A Systematic Review and Meta-Analysis

Background: Urologic cancers risk in patients with Ankylosing spondylitis (AS) remains uncertain. Therefore, we performed a systematic review and meta-analysis to investigate the association between AS and urologic cancers.Methods: PubMed, EMBASE, Web of Science, and Cochrane Library databases were searched to identify studies that recorded urologic cancers risk in AS patients from inception to October 2022. A random effects meta-analyses model was performed to estimated the relative risk (RR) and the 95% confidence intervals (CI).Results: A total of 7 cohort studies with 57,337 AS patients were included in this meta-analysis. Our results suggested that AS patients were at increased risk of urologic cancer (RR=1.42, 95%confidence interval [CI]: 1.25-1.62) but not of bladder cancer. Moreover, subgroup analyses showed an elevated risk of kidney cancer in patients with AS in western countries (RR, 1.70; 95% CI, 1.48–1.96). After adjusting for potential confounders, our findings still suggested that AS significantly increased the risk of kidney cancer (RR, 1.79; 95% CI, 1.53–2.10) and prostate cancer (RR, 1.73; 95% CI, 1.61–1.85).Conclusion: This study shows that AS significantly increases urologic cancer risk, especially in kidney cancer and prostate cancer, and further studies are needed to verify these results.