Cancer risk in a population-based cohort of patients hospitalized for psoriasis in Sweden
Cancer risk in a population-based cohort of patients hospitalized for psoriasis in Sweden
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DOI：
10.1046/j.0022-202x.2001.01520.x
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发表时间：
2001-12-01
影响因子：
6.5
通讯作者：
Lindelöf, B
中科院分区：
文献类型：
--
作者：
Boffetta, P;Gridley, G;Lindelöf, B
对银屑病患者的临床系列研究表明，非黑色素瘤皮肤癌和黑色素瘤的风险增加;其他肿瘤的风险很少被研究。为了评估瑞典全国范围内银屑病患者的癌症发病率，我们在1965-89年随访了9773例在1965-83年出院诊断为银屑病的患者，这些患者在首次出院后1年仍存活且无恶性肿瘤。通过计算标准化发病率（SIR），我们将他们的肿瘤发病率与全国人口进行了比较。我们共观察到789例肿瘤[SIR 1.37，95%置信区间（CI）1.28，1.47]。患口腔癌和咽癌的风险增加（SIR 2.80，95% CI 1.96，3.87），肝脏（SIR 1.91，95% CI 1.28，2.74），胰腺（SIR 1.56，95% CI 1.02，2.23），肺（SIR 2.13，95% CI 1.71，2.61），皮肤（鳞状细胞癌，SIR 2.46，95% CI 1.82，3.27），女性乳腺癌（SIR 1.27，95% CI 1.00，1.58），外阴（SIR 3.24，95% CI 1.18，7.06）、阴茎（SIR 4.66，95% CI 1.50，10.9）、膀胱（SIR 1.43，95% CI 1.03，1.92）和肾脏（SIR 1.56，95% CI 1.04，2.25）。恶性黑色素瘤的风险降低（SIR 0.32，95%CI 0.10，0.74）。尽管存在一些局限性（可能的诊断错误分类，缺乏治疗数据，随访时间相对较短），但我们的研究提供了证据，反对因银屑病住院的患者中黑色素瘤的风险增加。除了非黑色素瘤皮肤癌和生殖器癌外，因银屑病住院的患者患几种恶性肿瘤的风险增加，特别是与饮酒和吸烟相关的恶性肿瘤。
Studies of clinical series of psoriasis patients have suggested an increased risk of nonmelanoma skin cancer and melanoma; the risk of other neoplasms has rarely been studied. In order to assess the incidence of cancer in a nationwide series of psoriasis patients from Sweden, we followed up, for the years 1965-89, 9773 patients with a hospital discharge diagnosis of psoriasis made during 1965-83, who were alive and free from malignancy 1 y after first discharge. We compared their incidence of neoplasms with that of the national population by computing standardized incidence ratios (SIR). We observed a total of 789 neoplasms [SIR 1.37, 95% confidence interval (CI) 1.28, 1.47]. There was an increase in the risk of cancers of the oral cavity and pharynx (SIR 2.80, 95% CI 1.96, 3.87), liver (SIR 1.91, 95% CI 1.28, 2.74), pancreas (SIR 1.56, 95% CI 1.02, 2.23), lung (SIR 2.13, 95% CI 1.71, 2.61), skin (squamous cell carcinoma, SIR 2.46, 95% CI 1.82, 3.27), female breast (SIR 1.27, 95% CI 1.00, 1.58), vulva (SIR 3.24, 95% CI 1.18, 7.06), penis (SIR 4.66, 95% CI 1.50, 10.9), bladder (SIR 1.43, 95% CI 1.03, 1.92), and kidney (SIR 1.56, 95% CI 1.04, 2.25). The risk of malignant melanoma was decreased (SIR 0.32, 95% CI 0.10, 0.74). Despite some limitations (possible diagnostic misclassification, lack of data on treatment, relatively short follow-up), our study provides evidence against an increased risk of melanoma among patients hospitalized for psoriasis. In addition to nonmelanoma skin and genital cancers, patients hospitalized for psoriasis were at increased risk of several malignancies, in particular those associated with alcohol drinking and tobacco smoking.