Do you routinely take a cancer history from patients being evaluated for atopy?

There is a longstanding debate about the association of atopy with cancer risk. Significant literature evidence (mostly epidemiological) supports the notion that being atopic is protective against developing certain types of malignancies. The most commonly cited rationale is that this protection is associated with the immune status of the atopic individual (T2-directed allergen specific IgE activating mast cells). At least one of the presumed mechanisms of successful allergen immunotherapy is a change in the immune milieu from a T2 to a T1-based balance with increased Treg activity. Therefore, it is plausible to ask the question of whether, particularly in a patient with a strong family history of the relevant malignancy, discussion of this theoretical risk should be entertained prior to starting AIT.