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Increased cancer risk for patients with keloids

AAD 2019
A nationwide Taiwanese cohort study identified an augmented cancer risk in subjects with keloids when compared with those with normal wound healing [1].

Keloids are the result of abnormal wound healing that may happen after damage to the dermis due to trauma or injury. They are characterised by benign, fibrous proliferations that extend beyond the initial wound margins. The rationale for investigating a possible association between keloids and the risk for cancer was based on the knowledge that cancerous cell growth often starts in a sclerotic microenvironment. One focus of the investigation was placed on the occurrence of skin cancer. Data from almost 780,000 persons with an about equal distribution of males and females was analysed. In total, 17,401 adults with keloids were matched according to gender and age with 69,604 controls without keloids. Statistical identification of the relative risk for cancer was established using a Cox proportional hazards model. Both groups were comparable with regard to baseline characteristics.

In sum, 893 cases of cancer were newly diagnosed within the keloid group during the study years 1998-2010. This resulted in a 50% augmented overall cancer risk for the keloid-bearing study population. The overall relative risk for skin cancer turned out to be 1.73 in patients with a keloid. This risk was even higher for the males who had more than a 2-fold risk for skin cancer (relative risk 2.16). Women with keloids had an elevated risk for pancreatic cancer. Even after adjusting for known risk factors like liver cirrhosis, diabetes mellitus, and chronic pancreatitis, women with keloids still had a more than double the risk (relative risk 2.19). The authors suggest regular skin screenings in men and women with keloids, as well as ultrasound diagnostics for females as a preventive measure.

1. Hong KCH. Abstract 11228, AAD Annual Meeting, 1-5 March 2019, Washington DC, USA.

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