The findings suggest a need to conduct cancer screening by a detailed history and comprehensive clinical examination in patients with PsA.
A new study found that patients in Korea with psoriatic arthritis (PsA) have an increased risk of cancer compared with the general population.
Non-melanoma skin cancer, lymphoma, and thyroid cancer were listed specifically in the study, published in RMD Open. Researchers aimed to assess the risk of cancer in patients with PsA in a nationwide population-based cohort in South Korea from 2010 to June 2021. The outcome was the incidence of overall and specific cancers.
Investigators used data from the Health Insurance Review and Assessment Service (HIRA) database. The retrospective study included 4688 newly diagnosed patients with PsA between January 1, 2010
and June 30, 2021. The participants’ mean age was 49 years and 57% were men. Comorbidities such as diabetes and hypertension were more common in patients with PsA. The primary outcome was the incidence of cancer, and the secondary outcome was the incidence of specific cancer types. Participants were followed up from the index date until the occurrence of cancer, death, or the end of the study, whichever occurred first.
A total of 162 cancers occurred in the patients with PsA (incidence rate 83.2 [95% confidence interval (CI) 70.8 to 97.0] per 10,000 person-years) and 1307 cancers occurred in the controls (incidence rate 66.9 [95% CI 63.3 to 70.6] per 10,000 person-years). The adjusted HR (aHR) of overall cancer in patients with PsA was 1.20 (95% CI 1.02 to 1.41). When non-melanoma skin cancer was excluded, the risk of cancer did not show a significant increase in patients with PsA (aHR 1.16, 95% CI 0.98 to 1.37). Among specific cancers, the risk of non-melanoma skin cancer (aHR 3.64 [95% CI 1.61 to 8.23]), lymphoma (aHR 2.63 [95% CI 1.30 to 5.30]) and thyroid cancer (aHR 1.83 [95% CI 1.18 to 2.85]) was higher in patients with PsA than in the controls.
The study authors noted several limitations to the research. The mean age of the patients in the study was 49 years old, which may have contributed to the low incidence of cancer. They also stated that because the number of deaths was small, it was not feasible to conduct a meaningful analysis by considering death as a competing risk. In addition, comorbidites such as chronic obstructive lung disease, and lifestyle factors (such as smoking, or alcohol consumption) were not included in the analysis.
1. Eun Y, Hwang J, Seo GH, et al. Risk of cancer in Korean patients with psoriatic arthritis: a nationwide population-based cohort study. RMD Open. 2023;9(1):e002874. doi:10.1136/rmdopen-2022-002874