Abstract
Objective: Psoriasis is a chronic inflammatory disease and it is suggested that there may be an increased risk of malignancy because of immunological alterations and long-term immunosuppressive therapies. There are conflicting results and the association between psoriasis and malignancy is still unclear. The aim of this study was to investigate the risk of malignancy in patients with psoriasis.
Materials and Methods: In this retrospetive study, 1669 patients diagnosed with psoriasis between January 2013 and January 2018 in the electronic patient registration system of Manisa Celal Bayar University Hospital were enrolled in the study. The control group consisted of 3870 non-psoriatic patients randomly determined among patients who admitted to the dermatology clinic within the same time period. In both groups, cancer type and the age of the cancer diagnosis were recorded for those who had cancer diagnosis at least 1 month after the dermatologic diagnosis.
Results: The mean age of the psoriatic group was 40.33 (± 17.58) and the control group was 40.22 (± 16.91); women in the psoriatic group were 47.5% (n = 793) and 48.9% (n = 1892) in the control group. Cancers were present in 3.62% of the psoriatic group and 4.25% of the control group without statistical significance. There was no significant difference between the two groups in terms of cancer age or gender distribution of cancer patients. No significant effect of immunosuppressive drugs on cancer risk in psoriasis patients were detected in general or with related to any of the drugs.
Conclusion: In conclusion, no increased risk of malignancy due to psoriasis or the drugs used in the treatment of psoriasis was found in the five-year follow-up. As a retrospective study, lack of full control of every parameter that may increase cancer risk is the limitation of this study. Analyzing the patients on short-term therapy together may have statistically masked the cancer risk in patients receiving long-term therapy. Therefore, prospective randomized controlled trials that will last for many years are needed.
References
- Öztürk, F, Ermertcan, A.T, Gençoğlan, G, Temiz, P, İnanır, I, Isolated Face Involvement In Psoriasis, Celal Bayar Üniversitesi Sağlık Bilim Enstitüsü Dergisi, 2015, 2(4), 97-99.
- Chen, Y.J, Wu, C.Y, Chen, T.J, et al., The risk of cancer in patients with psoriasis: A population-based cohort study in Taiwan, The Journal of the American Academy of Dermatology, 2011, 65(1), 84-91.
- de Oliveira, M, de FSP, Rocha, B, de O, Duarte, G.V, Psoriasis: Classical and emerging comorbidities, Anais Brasileiros de Dermatologia, 2015, 90(1), 09-20.
- Çiftçi, N, Tarihi, G, Üniversitesi, G, et al., Hücre İçi Kalsiyum Sinyali, Apoptoz ve Kanser Progresyonunda Kalsiyum Kanallarının (Voc, Trp ve Soc Kanalları) Rolü, Celal Bayar Üniversitesi Sağlık Bilimleri Enstitüsü Dergisi, 2017, 4(3), 1021-1027.
- Balçık, Erçin, P, SIX1 ve Kanser Kök Hücre Belirteçlerinin Hepatoselluler Karsinomada Kapsamlı Analizi, Celal Bayar Üniversitesi Sağlık Bilim Enstitüsü Dergisi, 2020, 7(3), 325-330.
- Kabadayı, H, Kıvanç, M, Seda, Vatansever H, SALL4-STAT3 Relations In Primary And Metastatic Colon, Breast And Endometrial Cancer Cell Lines, Celal Bayar Üniversitesi Sağlık Bilimleri Enstitüsü Dergisi, 2016, 3(4), 460-465.
- Reddy, S.P, Martires, K, Wu, J.J, The risk of melanoma and hematologic cancers in patients with psoriasis, The Journal of the American Academy of Dermatology, 2017, 76(4), 639-647.
- Kimball, A.B, Schenfeld, J, Accortt, N.A, Anthony, M.S, Rothman, K.J, Pariser, D, Cohort study of malignancies and hospitalized infectious events in treated and untreated patients with psoriasis and a general population in the United States, British Journal of Dermatology, 2015, 173(5), 1183-1190.
- Fiorentino, D, Ho, V, Lebwohl, M.G, et al., Risk of malignancy with systemic psoriasis treatment in the Psoriasis Longitudinal Assessment Registry, The Journal of the American Academy of Dermatology, 2017, 77(5), 845-854.e5.
- Fuxench, Z.C.C, Shin, D.B, Beatty, A.O, Gelfand, J.M, The risk of cancer in patients with psoriasis a population-based cohort study in the health improvement network, JAMA Dermatology, 2016, 152(3), 282-290.
- Pouplard, C, Brenaut, E, Horreau, C, et al., Risk of cancer in psoriasis, A systematic review and meta-analysis of epidemiological studies, The Journal of the European Academy of Dermatology and Venereology, 2013, 27(SUPPL.3), 36-46.
- Geller, S, Xu, H, Lebwohl, M, Nardone, B, Lacouture, M.E, Kheterpal M, Malignancy Risk and Recurrence with Psoriasis and its Treatments: A Concise Update, The American Journal of Clinical Dermatology, 2018, 19(3), 363-375.
- Margolis, D, Bilker, W, Hennessy, S, Vittorio, C, Santanna, J, The risk of malignancy associated with psoriasis, Archives of Dermatology 2001, 137(6), 778–783.
- Naldi, L, Malignancy concerns with psoriasis treatments using phototherapy, methotrexate, cyclosporin, and biologics: facts and controversies, Clinics in Dermatology, 2010, 28(1), 88-92.
- Minimum Latency & Types or Categories of Cancer, https://www.cdc.gov/wtc/pdfs/policies/wtchpminlatcancer2014-11-07-508.pdf, 2014 (accessed 29.22.2020)
- Langley, R.G, Lebwohl, M, Krueger, G.G, et al., Long-term efficacy and safety of ustekinumab, with and without dosing adjustment, in patients with moderate-to-severe psoriasis: Results from the PHOENIX 2 study through 5 years of follow-up, British Journal of Dermatology, 2015, 172(5), 1371-1383.
Abstract
Giriş ve Amaç: Kronik inflamatuar bir hastalık olan psoriasisde, immünolojik değişiklikler ve uzun süreli kullanılan sistemik immünsüpresif tedaviler nedeniyle kanser riskinin arttığı düşünülmektedir. Bu konuda yapılan çalışmalarda çelişkili sonuçlar elde edilmiş, psoriasis ile malignite riski arasındaki ilişki henüz tam olarak aydınlatılamamıştır. Bu çalışmada psoriasisli hastalarda malignite riskinin araştırılması amaçlanmıştır.
Gereç ve Yöntemler: Manisa Celal Bayar Üniversite Hastanesi elektronik hasta kayıt sisteminden retrospektif tarama yapılarak, 2013 ile 2018 yılları arasında psoriasis tanısı olan 1669 hasta çalışmaya dahil edilmiştir. Aynı dönemde Dermatoloji polikliniğine başvuran ve psoriasis tanısı olmayan 3870 hasta kontrol grubu olarak değerlendirilmiştir. Her iki grupta, dermatolojik tanı aldıkları tarihten 1 ay sonrasından başlayarak kanserin tipi ve kanser tanısı aldıkları zaman kaydedilmiştir.
Bulgular: Psoriasis ve kontrol gruplarının yaş ortalamaları sırasıyla 40,33±17,58 ve 40,22±16,91 olarak bulunmuştur. Psoriasis grubunun %47,5’i (n=793), kontrol grubunun %48,9’u (n=1892) kadınlardan oluşmaktaydı. Kanser bulunma sıklığı psoriasis grubunda %3,62, kontrol grubunda %4,25 olup, istatistiksel olarak anlamlı farklılık saptanmamıştır. Psoriasisli hasta ve kontrol grubu arasında, kanser tanı yaşı, kanserli hastaların cinsiyet dağılımı açısından anlamlı farklılık bulunmamıştır. Herhangi bir immünsupresif ilaç öyküsü bulunmasının genel olarak, ya da ilaçlardan herhangi birinin psoriasis hastalarında kanser riski üzerine anlamlı etkisi saptanmamıştır.
Sonuç: Sonuç olarak, beş yıllık takipte psoriasise ya da psoriasis tedavisinde kullanılan ilaçlara bağlı olarak artmış bir malignite riski saptanmamıştır. Retrospektif bir çalışma olduğu için kanser riskini artırabilecek her parametrenin tam kontrolünün sağlanamaması bu çalışmanın kısıtlılığıdır. Kısa süreli tedavi alan hastaların da birlikte analiz edilmesi, uzun süre tedavi alan hastalarda kanser riskini istatistiksel olarak maskelemiş olabilir. Bu nedenle uzun yıllar sürecek şekilde planlanmış, prospektif randomize kontrollü çalışmaların gerçekleştirilmesine ihtiyaç vardır.
Keywords
References
- Öztürk, F, Ermertcan, A.T, Gençoğlan, G, Temiz, P, İnanır, I, Isolated Face Involvement In Psoriasis, Celal Bayar Üniversitesi Sağlık Bilim Enstitüsü Dergisi, 2015, 2(4), 97-99.
- Chen, Y.J, Wu, C.Y, Chen, T.J, et al., The risk of cancer in patients with psoriasis: A population-based cohort study in Taiwan, The Journal of the American Academy of Dermatology, 2011, 65(1), 84-91.
- de Oliveira, M, de FSP, Rocha, B, de O, Duarte, G.V, Psoriasis: Classical and emerging comorbidities, Anais Brasileiros de Dermatologia, 2015, 90(1), 09-20.
- Çiftçi, N, Tarihi, G, Üniversitesi, G, et al., Hücre İçi Kalsiyum Sinyali, Apoptoz ve Kanser Progresyonunda Kalsiyum Kanallarının (Voc, Trp ve Soc Kanalları) Rolü, Celal Bayar Üniversitesi Sağlık Bilimleri Enstitüsü Dergisi, 2017, 4(3), 1021-1027.
- Balçık, Erçin, P, SIX1 ve Kanser Kök Hücre Belirteçlerinin Hepatoselluler Karsinomada Kapsamlı Analizi, Celal Bayar Üniversitesi Sağlık Bilim Enstitüsü Dergisi, 2020, 7(3), 325-330.
- Kabadayı, H, Kıvanç, M, Seda, Vatansever H, SALL4-STAT3 Relations In Primary And Metastatic Colon, Breast And Endometrial Cancer Cell Lines, Celal Bayar Üniversitesi Sağlık Bilimleri Enstitüsü Dergisi, 2016, 3(4), 460-465.
- Reddy, S.P, Martires, K, Wu, J.J, The risk of melanoma and hematologic cancers in patients with psoriasis, The Journal of the American Academy of Dermatology, 2017, 76(4), 639-647.
- Kimball, A.B, Schenfeld, J, Accortt, N.A, Anthony, M.S, Rothman, K.J, Pariser, D, Cohort study of malignancies and hospitalized infectious events in treated and untreated patients with psoriasis and a general population in the United States, British Journal of Dermatology, 2015, 173(5), 1183-1190.
- Fiorentino, D, Ho, V, Lebwohl, M.G, et al., Risk of malignancy with systemic psoriasis treatment in the Psoriasis Longitudinal Assessment Registry, The Journal of the American Academy of Dermatology, 2017, 77(5), 845-854.e5.
- Fuxench, Z.C.C, Shin, D.B, Beatty, A.O, Gelfand, J.M, The risk of cancer in patients with psoriasis a population-based cohort study in the health improvement network, JAMA Dermatology, 2016, 152(3), 282-290.
- Pouplard, C, Brenaut, E, Horreau, C, et al., Risk of cancer in psoriasis, A systematic review and meta-analysis of epidemiological studies, The Journal of the European Academy of Dermatology and Venereology, 2013, 27(SUPPL.3), 36-46.
- Geller, S, Xu, H, Lebwohl, M, Nardone, B, Lacouture, M.E, Kheterpal M, Malignancy Risk and Recurrence with Psoriasis and its Treatments: A Concise Update, The American Journal of Clinical Dermatology, 2018, 19(3), 363-375.
- Margolis, D, Bilker, W, Hennessy, S, Vittorio, C, Santanna, J, The risk of malignancy associated with psoriasis, Archives of Dermatology 2001, 137(6), 778–783.
- Naldi, L, Malignancy concerns with psoriasis treatments using phototherapy, methotrexate, cyclosporin, and biologics: facts and controversies, Clinics in Dermatology, 2010, 28(1), 88-92.
- Minimum Latency & Types or Categories of Cancer, https://www.cdc.gov/wtc/pdfs/policies/wtchpminlatcancer2014-11-07-508.pdf, 2014 (accessed 29.22.2020)
- Langley, R.G, Lebwohl, M, Krueger, G.G, et al., Long-term efficacy and safety of ustekinumab, with and without dosing adjustment, in patients with moderate-to-severe psoriasis: Results from the PHOENIX 2 study through 5 years of follow-up, British Journal of Dermatology, 2015, 172(5), 1371-1383.
Details
| Primary Language | Turkish |
|---|---|
| Subjects | Dermatology |
| Journal Section | Araştırma Makalesi |
| Authors | |
| Publication Date | December 31, 2021 |
| Published in Issue | Year 2021 Volume: 8 Issue: 4 |
