Psoriasis is a chronic autoimmune condition primarily affecting the skin, characterized by an accelerated growth cycle of skin cells. This rapid turnover leads to the formation of thick, scaly patches, often appearing red or discolored, which can be itchy or painful. While not contagious, psoriasis is a lifelong condition that can fluctuate in severity, with periods of flare-ups and remission. The immune system mistakenly attacks healthy skin cells, leading to inflammation that manifests on the skin’s surface.
Psoriasis and Cancer Risk
Psoriasis does not directly cause cancer, but an association exists. Research indicates individuals with psoriasis may have an increased risk for certain cancers compared to the general population. This relationship is complex, not a simple cause-and-effect for every person. Epidemiological studies reveal a small but significant increased overall cancer risk in psoriasis patients.
The increased risk is particularly noted in those with more severe forms of psoriasis. While the absolute risk remains low, the association warrants attention. Concerns about this link arise from the chronic inflammatory nature of psoriasis, the use of certain immune-suppressing treatments, and the higher prevalence of established cancer risk factors among psoriasis patients.
Associated Cancer Types
Psoriasis has been linked to several specific cancer types. Non-melanoma skin cancers (NMSC), including squamous cell carcinoma (SCC) and basal cell carcinoma (BCC), are among the most frequently associated malignancies. Lymphomas, particularly cutaneous T-cell lymphoma (CTCL), also show a notable association with psoriasis.
Studies suggest an increased risk for Hodgkin lymphoma and non-Hodgkin lymphoma in individuals with psoriasis. Beyond skin and lymphatic system cancers, internal malignancies have also been implicated. These include lung cancer, bladder cancer, liver cancer, pancreatic cancer, and certain gastrointestinal cancers like colorectal, esophageal, and oral cancers. The association with lung cancer may be particularly pronounced in severe psoriasis, even when accounting for smoking status.
Understanding the Link
Several factors contribute to the connection between psoriasis and an increased cancer risk. Chronic systemic inflammation, a hallmark of psoriasis, can lead to cellular changes and DNA damage, creating an environment conducive to cancer development. The immune system dysregulation inherent in psoriasis, where immune cells are overactive, can also impact surveillance against cancerous cells.
Certain psoriasis treatments may also influence cancer risk. Phototherapy, specifically psoralen plus ultraviolet A (PUVA), has been associated with an increased risk of NMSC, particularly with higher cumulative doses. Systemic immunosuppressants like cyclosporine and methotrexate have also shown varying links to certain cancers, such as NMSC and lymphoma. While some biologics have raised concerns, current evidence largely indicates no significant increase in overall malignancy risk.
Shared lifestyle risk factors further complicate the relationship. Individuals with psoriasis often have a higher prevalence of habits such as smoking, alcohol consumption, and obesity, all of which are established risk factors for various cancers. These commonalities can independently contribute to cancer development, making it challenging to isolate the direct impact of psoriasis itself. Therefore, the link is likely multifactorial, involving the disease’s underlying biology, therapeutic interventions, and co-occurring lifestyle choices.
Reducing Your Risk
Managing psoriasis effectively is a primary step in mitigating associated cancer risks. Adhering to prescribed treatment plans, in close consultation with a dermatologist, helps control chronic inflammation. Controlling inflammation through consistent therapy can reduce one of the underlying drivers of increased cancer risk. Regular follow-up appointments allow for adjustments to treatment and ongoing assessment of overall health.
Regular cancer screenings are important for individuals with psoriasis. This includes routine skin checks for early detection of NMSC, especially for those with a history of phototherapy or other systemic treatments. Physicians may recommend other cancer screenings based on individual risk factors, age, and medical history. Early detection and intervention can significantly improve outcomes.
Adopting healthy lifestyle modifications can also help reduce cancer risk. Avoiding smoking and limiting alcohol intake are crucial, as these habits are independently linked to various cancers and are more prevalent in psoriasis patients. Maintaining a healthy weight through a balanced diet and regular physical activity supports overall health and reduces obesity-related cancer risks. Practicing sun protection, such as using sunscreen and protective clothing, is especially important for those undergoing phototherapy or with fair skin, to minimize skin cancer risk.