Risk of Head and Neck Cancer in Patients with Psoriasis: A Nationwide Population-based Study
DOI:
https://doi.org/10.2340/actadv.v104.18487Keywords:
psoriasis, head and neck cancer, nasopharyngeal cancer, salivary gland cancerAbstract
An association between psoriasis and cancer risk has been suggested in prior studies, but few have focused on head and neck cancers. Using the Korean National Health Insurance Service database, the relevance between psoriasis and head and neck cancer risks was investigated in a cross-sectional study of 3,869,264 individuals over 20 years of age, who received general health examination in 2009 and were followed until 2020. Head and neck cancer incidence rates were compared between individuals with and without psoriasis, and contributing factors were analysed. The head and neck cancer risk was significantly increased in the psoriasis group compared with the non-psoriasis group (hazard ratio [HR] 1.36; 95% confidence interval [CI] 1.07–1.74; p = 0.01) after adjusting for age, sex, body mass index, income, smoking, alcohol, exercise, diabetes mellitus, hypertension and dyslipidaemia. The risk was especially elevated for nasopharyngeal (HR 2.04; 95% CI 1.12–3.70; p = 0.02) and salivary gland cancer (HR 1.96; 95% CI 1.08–3.56; p = 0.03). Alcohol consumption significantly influenced the risk, particularly for oropharyngeal and oral cavity cancer. Our study provides insights into the potential risks of head and neck cancer in patients with psoriasis, which could aid in refining patient management strategies.
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References
Raharja A, Mahil SK, Barker JN. Psoriasis: a brief overview. Clin Med (Lond) 2021; 21: 170-173.
https://doi.org/10.7861/clinmed.2021-0257 DOI: https://doi.org/10.7861/clinmed.2021-0257
Michalek IM, Loring B, John SM. A systematic review of worldwide epidemiology of psoriasis. J Eur Acad Dermatol Venereol 2017; 31: 205-212.
https://doi.org/10.1111/jdv.13854 DOI: https://doi.org/10.1111/jdv.13854
Purzycka-Bohdan D, Kisielnicka A, Bohdan M, Szczerkowska-Dobosz A, Sobalska-Kwapis M, Nedoszytko B, et al. Analysis of the potential genetic links between psoriasis and cardiovascular risk factors. Int J Mol Sci 2021; 22: 9063.
https://doi.org/10.3390/ijms22169063 DOI: https://doi.org/10.3390/ijms22169063
Lonnberg AS, Skov L, Skytthe A, Kyvik KO, Pedersen OB, Thomsen SF. Association of psoriasis with the risk for type 2 diabetes mellitus and obesity. JAMA Dermatol 2016; 152: 761-767.
https://doi.org/10.1001/jamadermatol.2015.6262 DOI: https://doi.org/10.1001/jamadermatol.2015.6262
Multhoff G, Molls M, Radons J. Chronic inflammation in cancer development. Front Immunol 2011; 2: 98.
https://doi.org/10.3389/fimmu.2011.00098 DOI: https://doi.org/10.3389/fimmu.2011.00098
Gelfand JM, Berlin J, Van Voorhees A, Margolis DJ. Lymphoma rates are low but increased in patients with psoriasis: results from a population-based cohort study in the United Kingdom. Arch Dermatol 2003; 139: 1425-1429.
https://doi.org/10.1001/archderm.139.11.1425 DOI: https://doi.org/10.1001/archderm.139.11.1425
Trafford AM, Parisi R, Kontopantelis E, Griffiths CEM, Ashcroft DM. Association of psoriasis with the risk of developing or dying of cancer: a systematic review and meta-analysis. JAMA Dermatol 2019; 155: 1390-1403.
https://doi.org/10.1001/jamadermatol.2019.3056 DOI: https://doi.org/10.1001/jamadermatol.2019.3056
Lim SS, Lee W, Kim YK, Kim J, Park JH, Park BR, et al. The cumulative incidence and trends of rare diseases in South Korea: a nationwide study of the administrative data from the National Health Insurance Service database from 2011-2015. Orphanet J Rare Dis 2019; 14: 49.
https://doi.org/10.1186/s13023-019-1032-6 DOI: https://doi.org/10.1186/s13023-019-1032-6
Organization WH. The Asia-Pacific perspective: redefining obesity and its treatment. WHO, 2000.
Seo MH, Lee W-Y, Kim SS, Kang J-H, Kang J-H, Kim KK, et al. 2018 Korean Society for the Study of Obesity guideline for the management of obesity in Korea. J Obes Metab Syndr 2019; 28: 40.
https://doi.org/10.7570/jomes.2019.28.1.40 DOI: https://doi.org/10.7570/jomes.2019.28.1.40
Luu NM, Bui TT, Tran TPT, Nguyen THT, Oh J-K. Combinations of lifestyle behaviors and cancer risk among Korean adults. Sci Rep 2023; 13: 13765.
https://doi.org/10.1038/s41598-023-40819-w DOI: https://doi.org/10.1038/s41598-023-40819-w
Park S, Ahn J, Lee B-K. Very-low-fat diets may be associated with increased risk of metabolic syndrome in the adult population. Clin Nutr 2016; 35: 1159-1167.
https://doi.org/10.1016/j.clnu.2015.09.010 DOI: https://doi.org/10.1016/j.clnu.2015.09.010
Rosenberg DE, Bull FC, Marshall AL, Sallis JF, Bauman AE. Assessment of sedentary behavior with the International Physical Activity Questionnaire. J Phys Act Health 2008; 5: S30-44.
https://doi.org/10.1123/jpah.5.s1.s30 DOI: https://doi.org/10.1123/jpah.5.s1.s30
Lamb EJ, Tomson CR, Roderick PJ, Clinical Sciences Reviews Committee of the Association for Clinical B. Estimating kidney function in adults using formulae. Ann Clin Biochem 2005; 42: 321-345.
https://doi.org/10.1258/0004563054889936 DOI: https://doi.org/10.1258/0004563054889936
Lee JH, Kim HJ, Han KD, Kim HN, Park YM, Lee JY, et al. Cancer risk in 892 089 patients with psoriasis in Korea: a nationwide population-based cohort study. J Dermatol 2019; 46: 95-102.
https://doi.org/10.1111/1346-8138.14698 DOI: https://doi.org/10.1111/1346-8138.14698
Beyaert R, Beaugerie L, Van Assche G, Brochez L, Renauld JC, Viguier M, et al. Cancer risk in immune-mediated inflammatory diseases (IMID). Mol Cancer 2013; 12: 98.
https://doi.org/10.1186/1476-4598-12-98 DOI: https://doi.org/10.1186/1476-4598-12-98
Heidenreich R, Rocken M, Ghoreschi K. Angiogenesis drives psoriasis pathogenesis. Int J Exp Pathol 2009; 90: 232-248.
https://doi.org/10.1111/j.1365-2613.2009.00669.x DOI: https://doi.org/10.1111/j.1365-2613.2009.00669.x
Zarogoulidis P, Katsikogianni F, Tsiouda T, Sakkas A, Katsikogiannis N, Zarogoulidis K. Interleukin-8 and interleukin-17 for cancer. Cancer Invest 2014; 32: 197-205.
https://doi.org/10.3109/07357907.2014.898156 DOI: https://doi.org/10.3109/07357907.2014.898156
Pisarska MM, Dunne MR, O'Shea D, Hogan AE. Interleukin-17 producing mucosal associated invariant T cells: emerging players in chronic inflammatory diseases? Eur J Immunol 2020; 50: 1098-1108.
https://doi.org/10.1002/eji.202048645 DOI: https://doi.org/10.1002/eji.202048645
Tsao SW, Yip YL, Tsang CM, Pang PS, Lau VM, Zhang G, et al. Etiological factors of nasopharyngeal carcinoma. Oral Oncol 2014; 50: 330-338.
https://doi.org/10.1016/j.oraloncology.2014.02.006 DOI: https://doi.org/10.1016/j.oraloncology.2014.02.006
Pender MP. CD8+ T-cell deficiency, Epstein-Barr virus infection, vitamin D deficiency, and steps to autoimmunity: a unifying hypothesis. Autoimmune Dis 2012; 2012: 189096.
https://doi.org/10.1155/2012/189096 DOI: https://doi.org/10.1155/2012/189096
Mozaffari HR, Ramezani M, Janbakhsh A, Sadeghi M. Malignant salivary gland tumors and Epstein-Barr virus (EBV) infection: a systematic review and meta-analysis. Asian Pac J Cancer Prev 2017; 18: 1201-1206.
Tyszkiewicz T, Jarzab M, Szymczyk C, Kowal M, Krajewska J, Jaworska M, et al. Epidermal differentiation complex (locus 1q21) gene expression in head and neck cancer and normal mucosa. Folia Histochem Cytobiol 2014; 52: 79-89.
https://doi.org/10.5603/FHC.2014.0018 DOI: https://doi.org/10.5603/FHC.2014.0018
Hartman IZ, Kim A, Cotter RJ, Walter K, Dalai SK, Boronina T, et al. A reductionist cell-free major histocompatibility complex class II antigen processing system identifies immunodominant epitopes. Nat Med 2010; 16: 1333-1340.
https://doi.org/10.1038/nm.2248 DOI: https://doi.org/10.1038/nm.2248
Ho PY, Barton A, Worthington J, Plant D, Griffiths CE, Young HS, et al. Investigating the role of the HLA-Cw*06 and HLA-DRB1 genes in susceptibility to psoriatic arthritis: comparison with psoriasis and undifferentiated inflammatory arthritis. Ann Rheum Dis 2008; 67: 677-682.
https://doi.org/10.1136/ard.2007.071399 DOI: https://doi.org/10.1136/ard.2007.071399
Zong W, Ge Y, Han Y, Yang X, Li Q, Chen M. Hypomethylation of HLA-DRB1 and its clinical significance in psoriasis. Oncotarget 2017; 8: 12323-12332.
https://doi.org/10.18632/oncotarget.12468 DOI: https://doi.org/10.18632/oncotarget.12468
Yao K, Yang S, Shen J, Zhang R, Li L. HLA-DRB1 allele polymorphism and nasopharyngeal carcinoma risk: a meta-analysis. Eur Arch Otorhinolaryngol 2017; 274: 297-303.
https://doi.org/10.1007/s00405-016-4264-2 DOI: https://doi.org/10.1007/s00405-016-4264-2
Genetzakis M, Gomatos IP, Georgiou AN, Giotakis J, Manolopoulos L, Papadimitriou K, et al. BCL-2, p53 and HLA-DR antigen expression in surgically treated parotid cancer patients. Eur Arch Otorhinolaryngol 2009; 266: 417-424.
https://doi.org/10.1007/s00405-008-0754-1 DOI: https://doi.org/10.1007/s00405-008-0754-1
Anagnostouli M, Anagnostoulis G, Katsavos S, Panagiotou M, Kararizou E, Davaki P. HLA-DRB1 15:01 and Epstein-Barr virus in a multiple sclerosis patient with psoriasis, nasopharyngeal and breast cancers: lessons for possible hidden links for autoimmunity and cancer. J Neurol Sci 2014; 339: 26-31.
https://doi.org/10.1016/j.jns.2014.02.003 DOI: https://doi.org/10.1016/j.jns.2014.02.003
Auperin A. Epidemiology of head and neck cancers: an update. Curr Opin Oncol 2020; 32: 178-186.
https://doi.org/10.1097/CCO.0000000000000629 DOI: https://doi.org/10.1097/CCO.0000000000000629
Wei J, Zhu J, Xu H, Zhou D, Elder JT, Tsoi LC, et al. Alcohol consumption and smoking in relation to psoriasis: a Mendelian randomization study. Br J Dermatol 2022; 187: 684-691.
https://doi.org/10.1111/bjd.21718 DOI: https://doi.org/10.1111/bjd.21718
Näslund-Koch C, Vedel-Krogh S, Bojesen SE, Skov L. Smoking is an independent but not a causal risk factor for moderate to severe psoriasis: a Mendelian randomization study of 105,912 individuals. Front Immunol 2023; 14: 1119144.
https://doi.org/10.3389/fimmu.2023.1119144 DOI: https://doi.org/10.3389/fimmu.2023.1119144
Thiese MS, Ronna B, Ott U. P value interpretations and considerations. J Thorac Dis 2016; 8: E928-E931.
https://doi.org/10.21037/jtd.2016.08.16 DOI: https://doi.org/10.21037/jtd.2016.08.16
Brauchli YB, Jick SS, Miret M, Meier CR. Psoriasis and risk of incident cancer: an inception cohort study with a nested case-control analysis. J Invest Dermatol 2009; 129: 2604-2612.
https://doi.org/10.1038/jid.2009.113 DOI: https://doi.org/10.1038/jid.2009.113
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