Psoriasis Appears Associated With Increased Risk of Developing, Dying of Cancer

October 18, 2019

Patients with psoriasis appear to have an increased risk of cancer incidence and cancer-related mortality, according to a study published in JAMA Dermatology.

For the study, Alex Trafford, University of Manchester, Manchester, United Kingdom, and colleagues searched through 6 electronic databases and identified 58 observational studies that provided estimates of the risk of cancer incidence or cancer mortality associated with psoriasis.

The researchers found that severe psoriasis (risk ratio [RR] = 1.22; 95% confidence interval [CI], 1.08-1.39) and all severities of psoriasis (RR = 1.18; 95% CI, 1.06-1.31) were associated with an increased risk of cancer (overall), and associations were found for a range of site-specific cancers, including colon (RR = 1.18; 95% CI, 1.03-1.35), colorectal (RR = 1.34; 95% CI, 1.06-1.70), kidney (RR = 1.58; 95% CI, 1.11-2.24), laryngeal (RR = 1.79; 95% CI, 1.06-3.01), liver (RR = 1.83; 95% CI, 1.28-2.61), lymphoma (RR = 1.40; 95% CI, 1.24-1.57), non-Hodgkin lymphoma (RR = 1.28; 95% CI, 1.15-1.43), keratinocyte cancers (RR = 1.71; 95% CI, 1.08-2.71), oesophageal (RR = 2.05; 95% CI, 1.04-4.07), oral cavity (RR = 2.80; 95% CI, 1.99-3.93), and pancreatic (RR = 1.41; 95% CI, 1.16-1.73).

Overall cancer mortality risk was higher in patients with severe psoriasis (RR = 1.22; 95% CI, 1.08-1.38). Specifically, liver (RR = 1.43; 95% CI, 1.09-1.88), oesophageal (RR = 2.53; 95% CI, 1.87-3.41), and pancreatic (RR = 1.31; 95% CI, 1.02-1.69) cancer mortality were found to be elevated in those with severe psoriasis.

Despite stratification, the heterogeneity of estimates was often very high. Marked attenuation of risk was found in those studies that adjusted estimates for smoking, alcohol consumption, and obesity.

“Future research examining specific lifestyle factors, treatments, and the inflammatory processes that contribute to psoriasis may help provide additional information on the underlying mechanisms for the apparent increased cancer risk,” the authors concluded.

Reference: http://doi.org/10.1001/jamadermatol.2019.3056

SOURCE: JAMA Dermatology