Scoliosis and Cancer Risk: A Prospective Cohort Study of 441,206 Participants from the UK Biobank

Abstract Background While scoliosis is commonly considered a musculoskeletal condition, emerging evidence suggests it may be associated with increased cancer risk. However, large-scale, population-based studies assessing site-specific cancer risk in individuals with scoliosis are lacking. Methods We conducted a prospective cohort study using data from 441,206 participants in the UK Biobank. Participants with a baseline diagnosis of scoliosis were compared to those without scoliosis in terms of overall and site-specific cancer incidence. Multivariable Cox proportional hazards models were used to calculate adjusted hazard ratios (HRs) and 95% confidence intervals (CIs). Results During a median follow-up of 11.5 years, 659 (18%) of scoliosis patients and 64,651 (14.5%) of controls developed cancer. Scoliosis was associated with a modest but statistically significant increase in overall cancer risk (adjusted HR 1.089, 95% CI 1.009–1.176). Notably, scoliosis was significantly associated with increased risks of thyroid cancer (HR 2.625, 95% CI 1.399–4.928), skin squamous-cell carcinoma (HR 1.409, 95% CI 1.065–1.864), and prostate adenocarcinoma (HR 1.326, 95% CI 1.065–1.65). A negative association was observed for uterine corpus endometrial carcinoma (HR 0.517, 95% CI 0.268–0.995). Conclusion Individuals with scoliosis may be at increased risk for certain site-specific cancers, particularly of the thyroid, prostate, and skin. These findings highlight the need for a multidisciplinary approach in managing scoliosis, incorporating appropriate cancer risk assessment and screening strategies.