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Do Individuals With Psoriasis Have an Increased Risk of Keratinocyte Cancers?

By: Joseph Fanelli
Posted: Monday, November 4, 2019

According to a systematic review of numerous studies and a meta-analysis published in JAMA Dermatology, individuals with psoriasis appear to have an increased risk of developing cancer, and dying of it, across a “range of site-specific cancers.” Evangelos Kontopantelis, PhD, of the University of Manchester, United Kingdom, and colleagues stressed that further population-based studies are needed to understand the reasons for the link between psoriasis and cancer.

“Where possible, considering the association according to different severities of psoriasis would be beneficial,” the authors concluded. “Understanding the role of lifestyle factors in any increased cancer risk remains challenging, but studies giving greater consideration of these factors would be of benefit.”

The investigators searched 6 electronic databases for 58 cohort and case-control studies that provided estimates of the risk of cancer incidence or cancer mortality associated with psoriasis. Overall, severe psoriasis (relative risk = 1.22) and all severities of psoriasis (1.18) were associated with an increased risk of developing cancer. Associations for site-specific cancers—including colon cancer (relative risk = 1.18), colorectal (1.34), kidney (1.58), laryngeal (1.79), liver (1.83), lymphoma (1.40), non-Hodgkin lymphoma (1.28), keratinocyte cancers (1.71), esophageal (2.05), oral cavity (2.80), and pancreatic (1.41)—were found as well.

The authors discovered that cancer mortality risk was higher for patients with severe psoriasis (relative risk = 1.22), and specifically in those with liver (1.43), esophageal (2.53), and pancreatic cancers (1.31). In those studies that adjusted estimates for a patient’s smoking history, alcohol consumption, and obesity, there was a “marked attenuation of risk.”

“Carrying on a healthy lifestyle could potentially make a big difference in this risk,” said first study author Alex M. Trafford, MSc, also of the University of Manchester, in an article by Nicholas Bakalar in The New York Times.

Disclosure: For full disclosures of all study authors, visit jamanetwork.com.

 



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