Psoriasis may increase the risk of cancer incidence and cancer-related mortality in affected individuals, according to a new study.

The findings, which were published in JAMA Dermatology, suggest that cancer is an important comorbidity in patients with psoriasis that health care providers should be aware of.

With chronic inflammation previously linked to an increased cancer risk, it is plausible that the role of inflammation in the pathogenesis of psoriasis may contribute to the development of cancer as well, according to the study authors. Additionally, treatments with immunomodulatory therapies may also contribute to this risk.

The study included a systematic review and meta-analysis of 58 unique observational studies using data from 6 electronic databases. Data were analyzed from April 9, 2019, through February 22, 2019.

Overall, severe psoriasis and all severities of psoriasis were associated with an increased risk of cancer, with the association found across a range of site-specific cancers. Site-specific cancers linked to psoriasis included colon, colorectal, kidney, laryngeal, liver, lymphoma, non-Hodgkin lymphoma, keratinocyte cancers, esophageal, oral cavity, and pancreatic cancers.

Additionally, the analysis found that overall cancer mortality risk was higher in patients with severe psoriasis, specifically for liver, esophageal, and pancreatic cancers.

For all psoriasis severities, the data indicated a 1.18-fold increased risk of developing cancer compared with populations without psoriasis. Cohort studies of individuals with severe psoriasis showed a 1.22-fold increased risk compared with those without psoriasis. For cancer mortality, researchers observed a 1.22-fold increased risk of death due to cancer in severe psoriasis populations compared with those without psoriasis.

Despite these findings, the researchers noted that cancer receives relatively little focus when it comes to guiding the management of psoriasis compared with other comorbidities.

“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 through lifestyle behavior change,” the researchers wrote.

The prevalence of known cancer risk factors, such as smoking, excessive alcohol consumption, and obesity, has also been found to be greater in individuals with psoriasis. Implementing lifestyle modifications may help to reduce the risk of developing cancer associated with psoriasis, the researchers concluded.

References

Trafford AM, Parisi R, Kontopantelis E, et al. Association of psoriasis with the risk of developing or dying of cancer: A systematic review and meta-analysis. JAMA Dermatology. 2019. Doi: 10.1001/jamadermatol.2019.3056.