Rates of malignancies among patients with moderate to severe atopic dermatitis: a retrospective cohort study
Objectives Patients with atopic dermatitis (AD), also known as eczema, may be at an increased risk for malignancies compared with patients without AD; however, incidence rates (IRs) of malignancies in patients with moderate to severe AD are largely unknown. The objective of this study was to evaluat...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2023-03-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/13/3/e071172.full |
| _version_ | 1797744780993626112 |
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| author | Fei Xu Maryam M Asgari Jamie Geier Charles P Quesenberry Monique M Hedderson Sneha Sridhar Adina R Lemeshow |
| author_facet | Fei Xu Maryam M Asgari Jamie Geier Charles P Quesenberry Monique M Hedderson Sneha Sridhar Adina R Lemeshow |
| author_sort | Fei Xu |
| collection | DOAJ |
| description | Objectives Patients with atopic dermatitis (AD), also known as eczema, may be at an increased risk for malignancies compared with patients without AD; however, incidence rates (IRs) of malignancies in patients with moderate to severe AD are largely unknown. The objective of this study was to evaluate and compare IRs of malignancies in adults with moderate to severe AD (aged ≥18 years).Design Retrospective cohort study using data from a Kaiser Permanente Northern California (KPNC) cohort. AD severity classification was adjudicated with medical chart review. Covariates and stratification variables included age, sex and smoking status.Setting Data were obtained from the KPNC healthcare delivery system in northern California, USA. Cases of AD were defined by outpatient dermatologist-rendered codes and prescriptions of topical therapy or phototherapy (moderate) or systemic treatment (severe).Participants KPNC health plan members with moderate or severe AD (2007–2018).Primary and secondary outcome measures Malignancy IRs and 95% CIs per 1000 person-years were calculated.Results 7050 KPNC health plan members with moderate and severe AD met eligibility criteria for inclusion. IRs (95% CI) were highest for non-melanoma skin cancer (NMSC) in patients with moderate and severe AD (4.6 (95% CI 3.9 to 5.5) and 5.9 (95% CI 3.8 to 9.2), respectively) and breast cancer (2.2 (95% CI 1.6 to 3.0) and 0.5 (95% CI 0.1 to 3.9), respectively). Except for breast cancer, which was only evaluated in women, malignancies were higher (with non-overlapping CIs) in patients with moderate and moderate to severe AD in men versus women for basal cell carcinoma and NMSC and in former versus never smokers for NMSC and squamous cell carcinoma.Conclusions This study estimated IRs of malignancies in patients with moderate and severe AD and provides valuable information for dermatology clinicians and ongoing clinical trials in these populations. |
| first_indexed | 2024-03-12T15:14:08Z |
| format | Article |
| id | doaj.art-822e336823ec441f97a6df06eca955cb |
| institution | Directory Open Access Journal |
| issn | 2044-6055 |
| language | English |
| last_indexed | 2024-03-12T15:14:08Z |
| publishDate | 2023-03-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj.art-822e336823ec441f97a6df06eca955cb2023-08-11T17:35:07ZengBMJ Publishing GroupBMJ Open2044-60552023-03-0113310.1136/bmjopen-2022-071172Rates of malignancies among patients with moderate to severe atopic dermatitis: a retrospective cohort studyFei Xu0Maryam M Asgari1Jamie Geier2Charles P Quesenberry3Monique M Hedderson4Sneha Sridhar5Adina R Lemeshow61 Division of Research, Kaiser Permanente Northern California, Oakland, California, USA2 Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA3 Pfizer Inc, New York, New York, USA1 Division of Research, Kaiser Permanente Northern California, Oakland, California, USA1 Division of Research, Kaiser Permanente Northern California, Oakland, California, USA1 Division of Research, Kaiser Permanente Northern California, Oakland, California, USA3 Pfizer Inc, New York, New York, USAObjectives Patients with atopic dermatitis (AD), also known as eczema, may be at an increased risk for malignancies compared with patients without AD; however, incidence rates (IRs) of malignancies in patients with moderate to severe AD are largely unknown. The objective of this study was to evaluate and compare IRs of malignancies in adults with moderate to severe AD (aged ≥18 years).Design Retrospective cohort study using data from a Kaiser Permanente Northern California (KPNC) cohort. AD severity classification was adjudicated with medical chart review. Covariates and stratification variables included age, sex and smoking status.Setting Data were obtained from the KPNC healthcare delivery system in northern California, USA. Cases of AD were defined by outpatient dermatologist-rendered codes and prescriptions of topical therapy or phototherapy (moderate) or systemic treatment (severe).Participants KPNC health plan members with moderate or severe AD (2007–2018).Primary and secondary outcome measures Malignancy IRs and 95% CIs per 1000 person-years were calculated.Results 7050 KPNC health plan members with moderate and severe AD met eligibility criteria for inclusion. IRs (95% CI) were highest for non-melanoma skin cancer (NMSC) in patients with moderate and severe AD (4.6 (95% CI 3.9 to 5.5) and 5.9 (95% CI 3.8 to 9.2), respectively) and breast cancer (2.2 (95% CI 1.6 to 3.0) and 0.5 (95% CI 0.1 to 3.9), respectively). Except for breast cancer, which was only evaluated in women, malignancies were higher (with non-overlapping CIs) in patients with moderate and moderate to severe AD in men versus women for basal cell carcinoma and NMSC and in former versus never smokers for NMSC and squamous cell carcinoma.Conclusions This study estimated IRs of malignancies in patients with moderate and severe AD and provides valuable information for dermatology clinicians and ongoing clinical trials in these populations.https://bmjopen.bmj.com/content/13/3/e071172.full |
| spellingShingle | Fei Xu Maryam M Asgari Jamie Geier Charles P Quesenberry Monique M Hedderson Sneha Sridhar Adina R Lemeshow Rates of malignancies among patients with moderate to severe atopic dermatitis: a retrospective cohort study BMJ Open |
| title | Rates of malignancies among patients with moderate to severe atopic dermatitis: a retrospective cohort study |
| title_full | Rates of malignancies among patients with moderate to severe atopic dermatitis: a retrospective cohort study |
| title_fullStr | Rates of malignancies among patients with moderate to severe atopic dermatitis: a retrospective cohort study |
| title_full_unstemmed | Rates of malignancies among patients with moderate to severe atopic dermatitis: a retrospective cohort study |
| title_short | Rates of malignancies among patients with moderate to severe atopic dermatitis: a retrospective cohort study |
| title_sort | rates of malignancies among patients with moderate to severe atopic dermatitis a retrospective cohort study |
| url | https://bmjopen.bmj.com/content/13/3/e071172.full |
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