Department of Dermatology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania.
Division of Rheumatology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania; Center for Clinical Epidemiology and Biostatistics, Department of Biostatistics, Epidemiology and Informatics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania.
J Am Acad Dermatol. 2021 Jun;84(6):1602-1609. doi: 10.1016/j.jaad.2020.10.045. Epub 2020 Oct 23.
Psoriasis is associated with increased risk of developing and dying from cancer.
To evaluate whether psoriasis patients who are prescribed biologics receive the recommended screening for cervical, breast, and colon cancer.
We conducted a retrospective cohort study using the Optum deidentified Electronic Health Record data set. Incidence rates for cervical, breast, and colon cancer screening were compared between psoriasis patients who were prescribed biologics and 2 matched comparator cohorts: general patient population and patients being managed for hypertension. Multivariable Cox proportional hazards regression was performed to assess for differences in the rates of cancer screening.
Compared with those in the general population without psoriasis, psoriasis patients who were prescribed biologics had higher screening rates for cervical cancer (adjusted hazard ratio [aHR] 1.09; 95% confidence interval [CI] 1.02-1.16) and colon cancer (aHR 1.10; 95% CI 1.02-1.18). Compared with those with hypertension, patients with psoriasis who were prescribed biologics had lower screening rates for breast cancer (aHR 0.88; 95% CI 0.83-0.94) and colon cancer (aHR 0.89; 95% CI 0.83-0.95).
Patients with psoriasis who are prescribed biologic therapies may not be receiving adequate age-appropriate cancer screening, especially for breast and colon cancer.
银屑病与癌症发病和死亡风险增加有关。
评估接受生物制剂治疗的银屑病患者是否接受了推荐的宫颈癌、乳腺癌和结肠癌筛查。
我们使用 Optum 去标识电子健康记录数据集进行了回顾性队列研究。比较了接受生物制剂治疗的银屑病患者与 2 个匹配对照组（普通患者人群和高血压患者管理人群）的宫颈癌、乳腺癌和结肠癌筛查的发病率。采用多变量 Cox 比例风险回归评估癌症筛查率的差异。
与无银屑病的普通人群相比，接受生物制剂治疗的银屑病患者宫颈癌（调整后的危险比[aHR]1.09；95%置信区间[CI]1.02-1.16）和结肠癌（aHR 1.10；95% CI 1.02-1.18）的筛查率更高。与高血压患者相比，接受生物制剂治疗的银屑病患者乳腺癌（aHR 0.88；95% CI 0.83-0.94）和结肠癌（aHR 0.89；95% CI 0.83-0.95）的筛查率更低。
接受生物制剂治疗的银屑病患者可能未接受足够的适合年龄的癌症筛查，尤其是乳腺癌和结肠癌的筛查。
