Psoriasis associated with increased risk of some cancers in large study | JAMA Dermatol

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Takeaway

  • A large population-based study shows a small increased risk of certain cancers among all psoriasis patients, with the greatest risk among those with moderate to severe disease. 

Study design

  • Population-based cohort using a United Kingdom database of primary care medical records of patients ages 18 to 89 years with no medical history of human immunodeficiency virus, cancer, organ transplant, or hereditary disease prior to start date.
  • Patients with at least 1 diagnostic code for psoriasis were classified with moderate to severe disease if they had been prescribed psoralen, methotrexate, cyclosporine, acitretin, adalimumab, etanercept, infliximab, or ustekinumab, or treated with phototherapy.
  • Patients who did not receive those treatments were classified as having mild disease.

Key findings

  • 937,716 patients without psoriasis were the control group, matched by date and practice visit with 198,366 psoriasis patients (186,076 with mild psoriasis and 12,290 with moderate to severe psoriasis).
  • Adjusted hazard ratios (aHR) were greatest for lung cancer, non-melanoma skin cancer (NMSC), and lymphoma among those with moderate to severe psoriasis.
  • The aHR for lung cancer was 1.15 for all psoriasis patients (95% confidence interval [CI], 1.03-1.27); 1.12 for mild psoriasis (95% CI 1.01-1.25); 1.62 (95% CI, 1.16-2.28) for people with moderate to severe psoriasis.
  • The aHR for NMSC was 1.12 (95% CI 1.07-1.16) for all psoriasis patients, 1.09 (95% CI, 1.05-1.13) for patients with mild psoriasis; and 1.61 (95% CI, 1....