Abstract 874: Personal history of psoriasis and risk of incident cancer among women: the Nurses’ Health Study
Authors: Li Wen-Qing , Han Jiali , Cho Eunyoung , Wu Shaowei , Dai Hongji , Weinstock Martin , Qureshi Abrar 
Published: August 2015

Abstract
Background: Psoriasis has long been hypothesized to pose an increased risk of cancer due to the chronic, inflammatory state induced by psoriasis. Most prior studies on psoriasis and cancer were based on clinical settings, and the interest has been remarkably focused on the association between systemic therapies, typically only used in moderate-to-severe psoriasis, and risk of psoriasis. The evidence linking psoriasis with cancer is still controversial and few data are available from prospective studies. We systemically examined the association between a personal history of psoriasis and risk of incident cancer (other than skin basal cell carcinoma and squamous cell carcinoma).
Methods and Findings: A total of 64,990 participants were included from the Nurses’ Health Study (1996-2012). Diagnoses of cancers were obtained by biannual self-reported questionnaires and all cancers were confirmed. Clinician-diagnosed psoriasis and diagnosis year were collected in 2008 and validated with a supplementary questionnaire. We included 2180 cases with psoriasis and most had mild disease (92%). During 957,359 person-years’ follow-up, 8,348 incident cancers were documented. We did not find an altered risk of total cancer associated with personal history of psoriasis (multivariate-adjusted hazard ratio [HR] = 1.02; 95% CI: 0.89-1.17). However, for individual cancers, a personal history of psoriasis was associated with an increased risk of melanoma (HR = 1.94, 95% CI: 1.20-3.12) and kidney cancer (HR = 2.50, 95% CI: 1.27-4.92). The associations appeared stronger among psoriasis with 1 or more palm body surface area (BSA, P for trend 0.003 for melanoma and 0.0004 for kidney cancer), but remained significant even after exclusion of psoriasis with more than two palms’ BSA involvement.
Conclusions: We suggest a positive association between a personal history of psoriasis and risk of melanoma and renal cancer, which appears not be entirely a result of greater medical scrutiny or use of systemic therapies.
Personal history of psoriasis and risk of first primary cancerNo psoriasis (935,227 person-years)Psoriasis (22,132 person-years)Age-adjusted RRMultivariable-adjusted RRTotal cancer (other than keratinocyte carcinoma)81392091.06 (0.92-1.21)1.02 (0.89-1.17)Breast cancer4034860.91 (0.73-1.12)0.89 (0.71-1.10)Colorectal cancer697201.19 (0.76-1.86)1.11 (0.71-1.73)Non-Hodgkin lymphoma527131.01 (0.58-1.75)1.03 (0.59-1.78)Endometrial cancer51570.60 (0.28-1.26)0.54 (0.26-1.15)Lung cancer429141.23 (0.72-2.09)1.05 (0.61-1.79)Melanoma380182.00 (1.25-3.21)1.94 (1.20-3.12)Bladder cancer23271.20 (0.57-2.55)1.10 (0.52-2.35)Ovarian Cancer19461.25 (0.55-2.81)1.28 (0.56-2.88)Thyroid cancer15351.37 (0.56-3.33)1.36 (0.56-3.32)Kidney cancer13792.74 (1.40-5.39)2.50 (1.27-4.92)Other Cancers841241.03 (0.69-1.54)0.97 (0.65-1.46)
Citation Format: Wen-Qing Li, Jiali Han, Eunyoung Cho, Shaowei Wu, Hongji Dai, Martin Weinstock, Abrar Qureshi. Personal history of psoriasis and risk of incident cancer among women: the Nurses’ Health Study. [abstract]. In: Proceedings of the 106th Annual Meeting of the American Association for Cancer Research; 2015 Apr 18-22; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Res 2015;75(15 Suppl):Abstract nr 874. doi:10.1158/1538-7445.AM2015-874