Cancer y Psoriasis

Published in Dermatology

Journal Scan / Research · March 05, 2020

Prevalence, Incidence, and Risk of Cancer in Patients With Psoriasis and Psoriatic Arthritis

JAMA Dermatology

TAKE-HOME MESSAGE

• This meta-analysis evaluated 112 studies including 2,053,932 patients with psoriasis or psoriatic arthritis. There was a significant association between psoriasis and overall cancer risk, cancer excluding keratinocyte cancer, keratinocyte cancer, lymphomas, lung cancer, and bladder cancer.

• Studies did not show an increased risk of cancer in psoriasis patients treated with biologic medications. There was no increased risk associated with psoriatic arthritis; however, data on these patients were limited.

– Caitlyn T. Reed, MD

Abstract

IMPORTANCE

The association between psoriasis and risk of cancer remains debatable.

OBJECTIVE

To evaluate the association and risk of cancer in patients with psoriasis or psoriatic arthritis, including risk of specific cancer subtypes.

DATA SOURCES

Two databases (PubMed and Embase) were screened from inception to January 1, 2019, using the search string psoriasis or psoriatic and neoplasms or malignancy or cancer. The search was filtered to only include human participants and publications in English.

STUDY SELECTION

Observational cohort studies with a population of patients with psoriasis or psoriatic arthritis were included. Studies had to be original and report the incidence or prevalence of cancer within this population. Studies evaluating pediatric populations and cancer types not included in the protocol were excluded.

DATA EXTRACTION AND SYNTHESIS

This study was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. The search string, objectives, and study protocol methods were defined before the study was initiated. A total of 365 studies were included for full-text assessment. Owing to the heterogeneity of the included studies, a random-effects model was used.

MAIN OUTCOMES AND MEASURES

Main outcome was cancer (overall and specific subtypes) and measures were prevalence, incidence, and risk estimate for cancer in patients with psoriasis or psoriatic arthritis.

RESULTS

Of the 365 studies assessed, 112 were included in the analysis (N = 2 053 932 patients). The overall prevalence of cancer in patients with psoriasis was 4.78% (95% CI, 4.02%-5.59%), with an incidence rate of 11.75 per 1000 person-years (95% CI, 8.66-15.31) and a risk ratio (RR) of 1.21 (95% CI, 1.11-1.33). There was an increased risk of several cancers, including keratinocyte cancer (RR, 2.28; 95% CI, 1.73-3.01), lymphomas (RR, 1.56; 95% CI, 1.37-1.78), lung cancer (RR, 1.26; 95% CI, 1.13-1.40), and bladder cancer (RR, 1.12; 95% CI, 1.04-1.19). No increased risk of cancer for patients with psoriasis treated with biologic agents was found (RR, 0.97; 95% CI, 0.85-1.10). Psoriatic arthritis was not associated with increased risk of cancer overall (RR, 1.02; 95% CI, 0.97-1.08).

CONCLUSIONS AND RELEVANCE

Patients with psoriasis appear to have a slightly increased risk of cancer, particularly keratinocyte cancer and lymphomas. Data on treatment with biologic agents did not show an increased risk of cancer. Data on cancer in patients with psoriatic arthritis remain scarce, and further research is warranted in this area.

JAMA Dermatology

Prevalence, Incidence, and Risk of Cancer in Patients With Psoriasis and Psoriatic Arthritis: A Systematic Review and Meta-Analysis

JAMA Dermatol 2020 Feb 19;[EPub Ahead of Print], S Vaengebjerg, L Skov, A Egeberg, ND Loft 

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Benjamin Hidalgo-Matlock
Skin Care Physicians of Costa Rica

Clinica Victoria en San Pedro: 4000-1054
Momentum Escazu: 2101-9574

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