TOPLINE:

In a comprehensive analysis involving 700,000 patients with psoriasis across four countries, researchers found an increased risk for cancer overall and for multiple types of cancer. 

METHODOLOGY:

• Researchers conducted population-based cohort studies in four countries — Denmark, England, Israel, and Taiwan — using linked electronic health records.
• Participants included 702,022 adults (median age, 43-52 years; 42-51% women) with psoriasis and 4,185,342 matched individuals without psoriasis; 4%-10% of patients had moderate-to-severe psoriasis.
• The outcomes were any cancer diagnosis and site-specific cancer diagnosis.

TAKEAWAY:

• Psoriasis was associated with an overall 5% increased risk for cancer overall after adjustment for confounding factors (pooled hazard ratio [pHR], 1.05; 95% CI, 1.01-1.09). No association was observed between psoriasis and cancer in Denmark.
• Moderate-to-severe psoriasis was associated with a higher risk for cancer overall (pHR, 1.09; 95% CI, 1.03-1.15).
• Significant associations were found for the following cancers: oral cavity (pHR, 1.29), pharynx (pHR, 1.30), esophagus (pHR, 1.17), liver (pHR, 1.53), pancreas (pHR, 1.09), kidney (pHR, 1.19), Hodgkin lymphoma (pHR, 1.56), keratinocyte cancer (pHR, 1.37), non-Hodgkin lymphoma (pHR, 1.43), and leukemia (pHR, 1.61).
• Risk associations generally persisted and were exacerbated in patients with moderate-to-severe psoriasis, with additional associations noted for cancers of the lung and ovaries.

IN PRACTICE:

“We found an association between psoriasis and several incident site-specific cancers,” the authors wrote. “These findings,” they added, “emphasize the need to reinforce cancer prevention strategies in the care of psoriasis patients so as to reduce the cancer burden.”

SOURCE:

The study was led by Alex Trafford, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, England, and was published online on October 12 in the British Journal of Dermatology.

LIMITATIONS:

Cancer incidence varied by country, and psoriasis severity was based on treatment proxies rather than direct clinical scores. Lifestyle factors were not included in the analysis.

DISCLOSURES:

The study was funded by the International League of Dermatological Societies on behalf of the Global Psoriasis Atlas. Several authors reported receiving grants, consulting fees, advisory or speaker fees, and payments from AbbVie, Danish National Psoriasis Foundation, Eli Lilly, Janssen, Novartis, Pfizer, and various foundations. One author also reported acting as Chair for Diabetes UK, Professional conference organizing committee (2021-22) and Diabetes UK, Diabetes Research Steering Group 6. Additional disclosures are noted 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.