TOPLINE:

In a Danish study, patients with chronic lymphocytic leukemia (CLL) showed a higher risk for skin cancer, metastasis, and death than matched individuals at 10 years.

METHODOLOGY:

• Researchers conducted a population-based cohort study using Danish registry data from January 1990 to December 2020, analyzing 8352 patients with CLL matched 1:5 with 41,760 control individuals based on birth year, sex, geographic region, educational level, income, marital status, and Charlson Comorbidity Index (CCI) score.
• Their median age of patients was 70.7 years, 41.3% were female, and 80% had a CCI score of 0-1.
• Study outcomes were absolute risks and risk differences for overall skin cancer, basal cell carcinoma, squamous cell carcinoma, Merkel cell carcinoma, melanoma, cutaneous lymphoma, and skin cancer-specific metastasis and death.

TAKEAWAY:

• Patients with CLL had an absolute 10-year risk for skin cancer of 13.5% compared with 6.9% among controls (absolute risk difference, 6.6 percentage points; P < .001).
• The 10-year risk for basal cell carcinoma (8.6% vs 5.4%; P < .001) and squamous cell carcinoma (4.7% vs 1.4%; P < .001) was higher in patients with CLL than in control individuals. The risk for melanoma (1.0% vs 0.4%; P = .001) and cutaneous lymphoma (1.8 vs 0.1%; P < .001) was also higher among patients with CLL.
• Patients with CLL had a higher 10-year risk for skin cancer-specific metastasis (0.7% vs 0.1%; P < .001) and skin cancer-specific death (0.3% vs 0.1%; P = .004).
• All-cause mortality among patients with CLL was 56.3% compared with 39.3% among control individuals (absolute risk difference, 17.0 percentage points; P < .001).

IN PRACTICE:

In the study, “patients with CLL had a significantly higher absolute 10-year overall risk of developing skin cancer compared with a matched control group, corresponding to an approximately twofold increased risk across most skin cancer subtypes,” the authors of the study wrote. Screening patients with CLL, they added, “may be limited to resource-efficient surveillance strategies, such as self-examination, given the low risks of skin cancer-specific metastases and skin cancer-specific death compared with the high overall mortality.”

SOURCE:

The study was led by Astrid Merete Blomberg Drejøe, Department of Plastic Surgery and Burns Treatment, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark, and was published online on April 1 in JAMA Dermatology.

LIMITATIONS:

The study limitations included misclassification of outcomes, residual confounding, and surveillance bias. Lack of data on skin type and homogenous Fitzpatrick skin types of the Danish population makes the study less generalizable to other populations with darker skin types.

DISCLOSURES:

The authors did not disclose any funding source. Several authors reported receiving speaker fees, honoraria, grants, equipment, and personal fees from various companies, including Novo Nordisk, Novartis, AstraZeneca, Boehringer Ingelheim, Bayer, L’Oreal/La Roche-Posay, Venus Concepts Inc., and LEO Pharma. Full disclosures are reported in the original article.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.