We read with great interest the comprehensive meta-analysis by Shelton et al1 on cancer recurrence after immunosuppressive therapies in patients with immune-mediated diseases. The authors observed similar incidence rates of new cancers or cancer recurrence in patients with immune-mediated disease who received no immunosuppression, immune modulators, or anti-tumor necrosis factor therapy. They suggest that immunosuppressive therapy is not associated with an increased risk of cancer recurrence.