Gomez-Lara Alexander R, George Christopher D, Jiang Chen, Yin Jie, Kim Yuhree, Quesenberry Charles P, Jorgenson Eric, Madani Shabnam, Asgari Maryam M, Choquet Hélène
Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, California, USA.
Department of Dermatology, Stanford University School of Medicine, Palo Alto, California, USA.
JID Innov. 2025 Apr 22;5(4):100374. doi: 10.1016/j.xjidi.2025.100374. eCollection 2025 Jul.
Actinic keratosis (AK) is a precancerous lesion that develops on chronically sun-exposed skin. Immunosuppression is known to increase the risk of both AK and other cancers, highlighting the need to evaluate potential associations between AK and subsequent nonskin cancers. To determine whether a diagnosis of AK is associated with an increased subsequent incident of nonskin cancers, we conducted a retrospective case-control study within a large integrated healthcare delivery system. The study included 53,778 patients with AK and 152,896 controls without prior cancer diagnoses at enrollment. AK was more prevalent in males (30.7 vs 23.5% in females). AK was not associated with increased risk of overall nonskin cancers after adjusting for demographic (age, sex), clinical (body mass index, immunosuppression history), behavioral (smoking, alcohol use), and healthcare utilization factors (adjusted hazard ratio = 0.99, 95% confidence interval = 0.95-1.02). However, significant associations were observed between AK and breast (adjusted hazard ratio = 1.11, 95% confidence interval = 1.03-1.19) and prostate (adjusted hazard ratio =1.14, 95% confidence interval = 1.03-1.26) cancers. This large study reveals that AK may be a predictor of risk for subsequent cancers, notably breast and prostate cancers. These findings emphasize the need for increased surveillance for these cancer types in individuals with AK.
光化性角化病（AK）是一种发生在长期暴露于阳光下皮肤的癌前病变。已知免疫抑制会增加患AK和其他癌症的风险，这凸显了评估AK与后续非皮肤癌之间潜在关联的必要性。为了确定AK诊断是否与后续非皮肤癌的发病率增加相关，我们在一个大型综合医疗服务系统中进行了一项回顾性病例对照研究。该研究纳入了53778例患有AK的患者和152896例在入组时无癌症诊断史的对照。AK在男性中更为常见（男性为30.7%，女性为23.5%）。在调整了人口统计学（年龄、性别）、临床（体重指数、免疫抑制史）、行为（吸烟、饮酒）和医疗利用因素后，AK与总体非皮肤癌风险增加无关（调整后的风险比=0.99，95%置信区间=0.95-1.02）。然而，观察到AK与乳腺癌（调整后的风险比=1.11，95%置信区间=1.03-1.19）和前列腺癌（调整后的风险比=1.14，95%置信区间=1.03-1.26）之间存在显著关联。这项大型研究表明，AK可能是后续癌症风险的预测指标，尤其是乳腺癌和前列腺癌。这些发现强调了对患有AK的个体增加对这些癌症类型监测的必要性。
