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Published in: American Journal of Clinical Dermatology 1/2012

01-02-2012 | Original Research Article

Atopic Dermatitis and Risk of Skin Cancer

A Danish Nationwide Cohort Study (1977–2006)

Authors: Dr Annette O. Jensen, Claus Svaerke, Dora Körmendiné Farkas, Anne B. Olesen, Knud Kragballe, Henrik T. Sørensen

Published in: American Journal of Clinical Dermatology | Issue 1/2012

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Abstract

Background: Recent data suggest a reduced risk of malignant melanoma (MM) among atopic dermatitis (AD) patients, but an increased risk of other skin cancers (including basal cell carcinoma [BCC] and squamous cell carcinoma [SCC]).
Objective: We examined the association between AD and skin cancers in a large cohort study in Denmark from 1977 through 2006.
Methods: Our cohort consisted of 31 330 AD patients recorded in the Danish National Patient Registry, including AD patients admitted to hospitals and specialized outpatient clinics. Linkage to the Danish Cancer Registry allowed ascertainment of skin cancers. We calculated standardized incidence ratios (SIRs) and associated 95% confidence intervals (CIs) by comparing the incidence rate of skin cancers among AD patients with that among the general Danish population.
Results: The overall observed number of MM cases among AD patients was 12, with 21 expected, yielding a SIR of 0.59 (95% CI 0.30, 1.02), with the most pronounced protective effect among AD patients with more than 5 years of follow-up (SIR = 0.46; 95% CI 0.19, 0.95). The corresponding SIRs for BCC and SCC were increased among AD patients (1.41 [95% CI 1.07, 1.83] and 2.48 [95% CI 1.00, 5.11], respectively).
Conclusions: Our findings support an inverse association between AD and MM, but an increased risk of BCC and SCC among AD patients.
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Literature
1.
go back to reference Keil T, Kulig M, Simpson A, et al. European birth cohort studies on asthma and atopic diseases: I. Comparison of study designs: a GALEN initiative. Allergy 2006 Feb; 61 (2): 221–8 Keil T, Kulig M, Simpson A, et al. European birth cohort studies on asthma and atopic diseases: I. Comparison of study designs: a GALEN initiative. Allergy 2006 Feb; 61 (2): 221–8
2.
go back to reference Leiter U, Garbe C. Epidemiology of melanoma and nonmelanoma skin cancer: the role of sunlight. Adv Exp Med Biol 2008; 624: 89–103PubMedCrossRef Leiter U, Garbe C. Epidemiology of melanoma and nonmelanoma skin cancer: the role of sunlight. Adv Exp Med Biol 2008; 624: 89–103PubMedCrossRef
3.
go back to reference Synnerstad I, Fredrikson M, Ternesten-Bratel A, et al. Low risk of melanoma in patients with atopic dermatitis. J Eur Acad Dermatol Venereol 2008 Dec; 22 (12): 1423–8 Synnerstad I, Fredrikson M, Ternesten-Bratel A, et al. Low risk of melanoma in patients with atopic dermatitis. J Eur Acad Dermatol Venereol 2008 Dec; 22 (12): 1423–8
4.
go back to reference Hagstromer L, Ye W, Nyren O, et al. Incidence of cancer among patients with atopic dermatitis. Arch Dermatol 2005 Sep; 141 (9): 1123–7 Hagstromer L, Ye W, Nyren O, et al. Incidence of cancer among patients with atopic dermatitis. Arch Dermatol 2005 Sep; 141 (9): 1123–7
5.
go back to reference Olesen AB, Engholm G, Storm HH, et al. The risk of cancer among patients previously hospitalized for atopic dermatitis. J Invest Dermatol 2005 Sep; 125 (3): 445–9 Olesen AB, Engholm G, Storm HH, et al. The risk of cancer among patients previously hospitalized for atopic dermatitis. J Invest Dermatol 2005 Sep; 125 (3): 445–9
6.
go back to reference Ji J, Shu X, Li X, et al. Cancer risk in hospitalised asthma patients. Br J Cancer 2009 Mar 10; 100 (5): 829–33 Ji J, Shu X, Li X, et al. Cancer risk in hospitalised asthma patients. Br J Cancer 2009 Mar 10; 100 (5): 829–33
7.
go back to reference Frank L. Epidemiology: when an entire country is a cohort. Science 2000 Mar 31; 287 (5462): 2398–9 Frank L. Epidemiology: when an entire country is a cohort. Science 2000 Mar 31; 287 (5462): 2398–9
8.
go back to reference Andersen TF, Madsen M, Jorgensen J, et al. The Danish National Hospital Register: a valuable source of data for modern health sciences. Dan Med Bull 1999 Jun; 46 (3): 263–8 Andersen TF, Madsen M, Jorgensen J, et al. The Danish National Hospital Register: a valuable source of data for modern health sciences. Dan Med Bull 1999 Jun; 46 (3): 263–8
9.
go back to reference Adami J, Gabel H, Lindelof B, et al. Cancer risk following organ transplantation: a nationwide cohort study in Sweden. Br J Cancer 2003 Oct 6; 89 (7): 1221–7 Adami J, Gabel H, Lindelof B, et al. Cancer risk following organ transplantation: a nationwide cohort study in Sweden. Br J Cancer 2003 Oct 6; 89 (7): 1221–7
10.
go back to reference Jensen AO, Olesen AB, Dethlefsen C, et al. Chronic diseases requiring hospitalization and risk of non-melanoma skin cancers: a population based study from Denmark. J Invest Dermatol 2008 Apr; 128 (4): 926–31 Jensen AO, Olesen AB, Dethlefsen C, et al. Chronic diseases requiring hospitalization and risk of non-melanoma skin cancers: a population based study from Denmark. J Invest Dermatol 2008 Apr; 128 (4): 926–31
11.
go back to reference Storm HH, Michelsen EV, Clemmensen IH, et al. The Danish Cancer Registry: history, content, quality and use. Dan Med Bull 1997 Nov; 44 (5): 535–9 Storm HH, Michelsen EV, Clemmensen IH, et al. The Danish Cancer Registry: history, content, quality and use. Dan Med Bull 1997 Nov; 44 (5): 535–9
12.
go back to reference Breslow NE, Day NE. Statistical methods in cancer research: volume II. The design and analysis of cohort studies. IARC Sci Publ 1987; (82): 1–406 Breslow NE, Day NE. Statistical methods in cancer research: volume II. The design and analysis of cohort studies. IARC Sci Publ 1987; (82): 1–406
13.
go back to reference Rothman KJ. Epidemiology: an introduction. New York (NY): Oxford University Press, 2002 Rothman KJ. Epidemiology: an introduction. New York (NY): Oxford University Press, 2002
14.
go back to reference Mittelman A, Chen ZJ, Liu CC, et al. Kinetics of the immune response and regression of metastatic lesions following development of humoral anti-high molecular weight-melanoma associated antigen immunity in three patients with advanced malignant melanoma immunized with mouse antiidiotypic monoclonal antibody MK2-23. Cancer Res 1994 Jan 15; 54 (2): 415–21 Mittelman A, Chen ZJ, Liu CC, et al. Kinetics of the immune response and regression of metastatic lesions following development of humoral anti-high molecular weight-melanoma associated antigen immunity in three patients with advanced malignant melanoma immunized with mouse antiidiotypic monoclonal antibody MK2-23. Cancer Res 1994 Jan 15; 54 (2): 415–21
15.
go back to reference Mukherji B, Chakraborty NG. Immunobiology and immunotherapy of melanoma. Curr Opin Oncol 1995 Mar; 7 (2): 175–84 Mukherji B, Chakraborty NG. Immunobiology and immunotherapy of melanoma. Curr Opin Oncol 1995 Mar; 7 (2): 175–84
16.
go back to reference Leung DY, Boguniewicz M, Howell MD, et al. New insights into atopic dermatitis. J Clin Invest 2004 Mar; 113 (5): 651–7 Leung DY, Boguniewicz M, Howell MD, et al. New insights into atopic dermatitis. J Clin Invest 2004 Mar; 113 (5): 651–7
17.
go back to reference Swope VB, Abdel-Malek Z, Kassem LM, et al. Interleukins 1 alpha and 6 a nd tumor necrosis factor-alpha are paracrine inhibitors of human melanocyte proliferation and melanogenesis. J Invest Dermatol 1991 Feb; 96 (2): 180–5 Swope VB, Abdel-Malek Z, Kassem LM, et al. Interleukins 1 alpha and 6 a nd tumor necrosis factor-alpha are paracrine inhibitors of human melanocyte proliferation and melanogenesis. J Invest Dermatol 1991 Feb; 96 (2): 180–5
18.
go back to reference Krasagakis K, Garbe C, Eberle J, et al. Tumour necrosis factors and several interleukins inhibit the growth and modulate the antigen expression of normal human melanocytes in vitro. Arch Dermatol Res 1995; 287 (3-4): 259–65PubMedCrossRef Krasagakis K, Garbe C, Eberle J, et al. Tumour necrosis factors and several interleukins inhibit the growth and modulate the antigen expression of normal human melanocytes in vitro. Arch Dermatol Res 1995; 287 (3-4): 259–65PubMedCrossRef
19.
go back to reference Broberg A, Augustsson A. Atopic dermatitis and melanocytic naevi. Br J Dermatol 2000 Feb; 142 (2): 306–9 Broberg A, Augustsson A. Atopic dermatitis and melanocytic naevi. Br J Dermatol 2000 Feb; 142 (2): 306–9
20.
go back to reference Swerdlow AJ, English J, MacKie RM, et al. Benign naevi associated with high risk of melanoma [letter]. Lancet 1984 Jul 21; 2 (8395): 168 Swerdlow AJ, English J, MacKie RM, et al. Benign naevi associated with high risk of melanoma [letter]. Lancet 1984 Jul 21; 2 (8395): 168
21.
go back to reference Holly EA, Kelly JW, Shpall SN, et al. Number of melanocytic nevi as a major risk factor for malignant melanoma. J Am Acad Dermatol 1987 Sep; 17 (3): 459–68 Holly EA, Kelly JW, Shpall SN, et al. Number of melanocytic nevi as a major risk factor for malignant melanoma. J Am Acad Dermatol 1987 Sep; 17 (3): 459–68
22.
go back to reference Holman CD, Armstrong BK. Pigmentary traits, ethnic origin, benign nevi, and family history as risk factors for cutaneous malignant melanoma. J Natl Cancer Inst 1984 Feb; 72 (2): 257–66 Holman CD, Armstrong BK. Pigmentary traits, ethnic origin, benign nevi, and family history as risk factors for cutaneous malignant melanoma. J Natl Cancer Inst 1984 Feb; 72 (2): 257–66
23.
go back to reference Lea CS, Scotto JA, Buffler PA, et al. Ambient UVB and melanoma risk in the United States: a case-control analysis. Ann Epidemiol 2007 Jun; 17 (6): 447–53 Lea CS, Scotto JA, Buffler PA, et al. Ambient UVB and melanoma risk in the United States: a case-control analysis. Ann Epidemiol 2007 Jun; 17 (6): 447–53
24.
go back to reference Sorensen HT, Mellemkjaer L, Nielsen GL, et al. Skin cancers and non- Hodgkin lymphoma among users of systemic glucocorticoids: a populationbased cohort study. J Natl Cancer Inst 2004 May 5; 96 (9): 709–11 Sorensen HT, Mellemkjaer L, Nielsen GL, et al. Skin cancers and non- Hodgkin lymphoma among users of systemic glucocorticoids: a populationbased cohort study. J Natl Cancer Inst 2004 May 5; 96 (9): 709–11
25.
go back to reference Jensen AO, Thomsen HF, Engebjerg MC, et al. Use of oral glucocorticoids and risk of skin cancer and non-Hodgkins lymphoma: a population-based case-control study. Br J Cancer 2009 Jan 13; 100 (1): 200–5 Jensen AO, Thomsen HF, Engebjerg MC, et al. Use of oral glucocorticoids and risk of skin cancer and non-Hodgkins lymphoma: a population-based case-control study. Br J Cancer 2009 Jan 13; 100 (1): 200–5
26.
go back to reference Madan V, Lear JT, Szeimies RM. Non-melanoma skin cancer. Lancet Feb 20; 375 (9715): 673–85 Madan V, Lear JT, Szeimies RM. Non-melanoma skin cancer. Lancet Feb 20; 375 (9715): 673–85
27.
go back to reference Stern RS, Liebman EJ, Vakeva L. Oral psoralen and ultraviolet-Alight (PUVA) treatment of psoriasis and persistent risk of nonmelanoma skin cancer: PUVA Follow-up Study. J Natl Cancer Inst 1998 Sep 2; 90 (17): 1278–84 Stern RS, Liebman EJ, Vakeva L. Oral psoralen and ultraviolet-Alight (PUVA) treatment of psoriasis and persistent risk of nonmelanoma skin cancer: PUVA Follow-up Study. J Natl Cancer Inst 1998 Sep 2; 90 (17): 1278–84
28.
go back to reference Rosso S, Zanetti R, Martinez C, et al. The multicentre south European study Helios: II. Different sun exposure patterns in the aetiology of basal cell and squamous cell carcinomas of the skin. Br J Cancer 1996 Jun; 73 (11): 1447–54 Rosso S, Zanetti R, Martinez C, et al. The multicentre south European study Helios: II. Different sun exposure patterns in the aetiology of basal cell and squamous cell carcinomas of the skin. Br J Cancer 1996 Jun; 73 (11): 1447–54
29.
go back to reference Ming ME, Levy R, Hoffstad O, et al. The lack of a relationship between atopic dermatitis and nonmelanoma skin cancers. J Am Acad Dermatol 2004 Mar; 50 (3): 357–62 Ming ME, Levy R, Hoffstad O, et al. The lack of a relationship between atopic dermatitis and nonmelanoma skin cancers. J Am Acad Dermatol 2004 Mar; 50 (3): 357–62
30.
go back to reference Olesen AB, Ellingsen AR, Olesen H, et al. Atopic dermatitis and birth factors: historical follow up by record linkage. BMJ 1997 Apr 5; 314 (7086): 1003–8 Olesen AB, Ellingsen AR, Olesen H, et al. Atopic dermatitis and birth factors: historical follow up by record linkage. BMJ 1997 Apr 5; 314 (7086): 1003–8
31.
go back to reference Mills CM, Srivastava ED, Harvey IM, et al. Cigarette smoking is not a risk factor in atopic dermatitis. Int J Dermatol 1994 Jan; 33 (1): 33–4 Mills CM, Srivastava ED, Harvey IM, et al. Cigarette smoking is not a risk factor in atopic dermatitis. Int J Dermatol 1994 Jan; 33 (1): 33–4
Metadata
Title
Atopic Dermatitis and Risk of Skin Cancer
A Danish Nationwide Cohort Study (1977–2006)
Authors
Dr Annette O. Jensen
Claus Svaerke
Dora Körmendiné Farkas
Anne B. Olesen
Knud Kragballe
Henrik T. Sørensen
Publication date
01-02-2012
Publisher
Springer International Publishing
Published in
American Journal of Clinical Dermatology / Issue 1/2012
Print ISSN: 1175-0561
Electronic ISSN: 1179-1888
DOI
https://doi.org/10.2165/11593280-000000000-00000

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