People with psoriasis may have an increased risk for cancer and cancer-related mortality, according to a systematic review and meta-analysis recently published in JAMA Oncology. When confounding variables were controlled for, the association between psoriasis and cancer risk and mortality appeared to weaken, suggesting that lifestyle changes may mitigate these risks.

The study included 58 observational studies that assessed the risk of cancer incidence and cancer-related mortality in people with psoriasis. Among these studies, 50 evaluated the risk of cancer and 15 evaluated cancer-related mortality; 7 studies evaluated both.

Psoriasis of any severity was correlated with a heightened risk of cancer (relative risk [RR], 1.18; 95% CI, 1.06-1.31), and this heightened risk was for several cancer types, including colon, colorectal, kidney, laryngeal, liver, lymphoma, non-Hodgkin lymphoma, keratinocyte cancers, esophageal, oral cavity, and pancreatic. No association was seen between any-severity psoriasis and cancer-related mortality.

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Severe psoriasis was also correlated with a heightened risk of cancer (RR, 1.22; 95% CI, 1.08-1.39), and with a higher cancer-related mortality (RR, 1.22; 95% CI, 1.08-1.38), and this higher risk was across select cancer types, including liver, esophageal, and pancreatic.


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When only studies that considered confounding variables beyond age and sex were included, the cancer incidence risk for all severities of psoriasis lessened (RR, 1.07; 95% CI, 1.03-1.10). The risk of mortality similarly also lessened (RR, 1.15; 95% CI, 0.94-1.41).

“The evidence from this meta-analysis not only suggests that cancer should be given more consideration as an important comorbidity of psoriasis but also begins to present evidence that this risk could be alleviated to some extent through lifestyle behavior change,” the study authors wrote.

Disclosure: Some of the authors reported the receipt of financial support from pharmaceutical and medical device industries. For a full list of disclosures, please refer to the original study.

Reference

Trafford AM, Parisi R, Kontopantelis E, Griffiths CEM, and Ashcroft DM. Association of psoriasis with the risk of developing or dying of cancer: A systematic review and meta-analysis [published online October 16, 2019]. JAMA Dermatol. doi: 10.1001/jamadermatol.2019.3056