Sørensen Sissel B T, Farkas Dóra K, Vestergaard Christian, Schmidt Sigrun A J, Lindahl Lise Maria, Mansfield Kathryn E, Langan Sinead M, Sørensen Henrik T
Department of Dermatology, Aarhus University Hospital, Aarhus, Denmark.
Department of Rheumatology, Aarhus University Hospital, Aarhus, Denmark.
Br J Dermatol. 2024 Oct 17;191(5):706-712. doi: 10.1093/bjd/ljae264.
Urticaria has been tentatively linked to cancer, but epidemiological evidence supporting this link is sparse and conflicting. We conducted a population-based cohort study using healthcare databases covering the Danish population (January 1980-December 2022). We followed 87 507 people for a median of 10.1 years after their first hospital contact for urticaria.
To examine associations of a hospital diagnosis of urticaria with incident cancer.
We computed the absolute risk of cancer and standardized incidence ratios (SIRs) with 95% confidence intervals (CIs) standardized to Danish national cancer rates. In a cross-sectional analysis, we examined whether the extent of cancer spread differed between people with vs. without a previous urticaria diagnosis.
The overall SIR for all types of cancer was 1.09 (95% CI 1.06-1.11) based on 7788 observed vs. 7161 expected cases. The risk for any cancer was 0.7% (95% CI 0.6-0.7) for the first year of follow-up. Cancer was diagnosed in 588 people with urticaria during the first year of follow-up (SIR 1.49, 95% CI 1.38-1.62) and in 7200 people thereafter (SIR 1.06, 95% CI 1.04-1.09). During the first year of follow-up, we found strong associations with haematological cancers (e.g. non-Hodgkin lymphoma; SIR 2.91, 95% CI 1.92-4.23). Cancer stage was similar in people with vs. without a previous urticaria diagnosis.
At the time of urticaria diagnosis, or in the first year afterward, we found a large increase in the risk of cancer. In subsequent years, a persistent 6% increase in risk remained. Diagnostic efforts may partly explain the elevated short-term risk, but occult cancer may promote urticaria, or cancer and urticaria share common risk factors.
荨麻疹已被初步认为与癌症有关，但支持这种关联的流行病学证据稀少且相互矛盾。我们利用涵盖丹麦人口（1980年1月至2022年12月）的医疗保健数据库进行了一项基于人群的队列研究。在首次因荨麻疹住院后，我们对87507人进行了为期10.1年的中位数随访。
研究医院诊断的荨麻疹与新发癌症之间的关联。
我们计算了癌症的绝对风险以及标准化发病率（SIR），并给出95%置信区间（CI），该区间是根据丹麦国家癌症发病率进行标准化的。在横断面分析中，我们研究了既往有荨麻疹诊断与无荨麻疹诊断的人群之间癌症扩散程度是否存在差异。
基于7788例观察到的病例与7161例预期病例，所有类型癌症的总体标准化发病率为1.09（95%CI 1.06 - 1.11）。随访第一年中任何癌症的风险为0.7%（95%CI 0.6 - 0.7）。在随访的第一年，588例荨麻疹患者被诊断出患有癌症（标准化发病率为1.49，95%CI 1.38 - 1.62），之后有7200例（标准化发病率为1.06，95%CI 1.04 - 1.09）。在随访的第一年，我们发现与血液系统癌症（如非霍奇金淋巴瘤；标准化发病率为2.91，95%CI 1.92 - 4.23）有很强的关联。既往有荨麻疹诊断与无荨麻疹诊断的人群的癌症分期相似。
在荨麻疹诊断时或之后的第一年，我们发现患癌风险大幅增加。在随后几年中，风险持续增加6%。诊断性检查可能部分解释了短期风险升高的原因，但隐匿性癌症可能会引发荨麻疹，或者癌症和荨麻疹有共同的风险因素。
