Markedly lower skin cancer risk in vitiligo patients

The risk to develop any kind of skin cancer is 38% lower for patients suffering from vitiligo. A significantly lower risk was also found when differentiating according to individual skin cancer type.

Current data on the skin cancer risk in vitiligo patients is not consistent in its results. “There has been a big lack of, particularly European, population-based studies,” Dr John Ferguson (St John’s Institute of Dermatology, UK) pointed out [1]. To clarify the question, the British investigator team performed a matched retrospective cohort study utilising data from the Optimum Patient Care Research Database (opcrd.co.uk) which contains medical care records from about 10 million UK patients. They matched 60,615 controls to 15,156 patients with vitiligo according to e.g. age, sex, and ethnicity. The participants were registered in the database between 2010 and 2020. A composite of melanoma and non-melanoma skin cancer occurrence was the primary endpoint. Secondary outcomes were individual cancer forms like melanoma, squamous cell carcinoma (SCC), and basal cell carcinoma (BCC).

The characteristics of the study cohort included a median age of 47 and an average follow-up of about 8 years in a study population with 54.5% women. “Around 70% of participants were White, which is slightly lower than the UK population, which kind of makes sense given this condition particularly affects people with darker skin prototypes,” Dr Ferguson told.

The results demonstrated a 10-year cumulative skin cancer incidence of 1.3% in vitiligo patients compared with 2% in controls. The adjusted hazard ratio (aHR) of 0.62 (95% CI 0.52-0.75) stood for a 38% reduction in risk for any kind of skin cancer (see Figure). Hazard ratios were also significant for the individual cancer types: melanoma aHR 0.39 (P<0.001), SCC aHR 0.67(P<0.01), BCC aHR 0.65 (P<0.001). Concerning actinic keratosis, however, no significant risk-lowering association with vitiligo was discovered.

Figure: Patients with vitiligo carry a lower risk for both melanoma and non-melanoma skin cancer [1]



***, P<0.001; **, P<0.01; *, P<0.05; †, adjusted for age, sex, IMD, ethnicity, BMI, smoking status, alcohol status, history of immunotherapy, phototherapy, and major comorbidities.

“Looking into the demographics, this effect is consistent for men and women and different socioeconomic groups,” Dr Ferguson informed. In his opinion, the lack of significance for the non-White study population was due to a rather low cancer incidence rate and inadequate power in this subgroup to detect differences.

“We should think of this as being reassuring considering we use phototherapy, we use protopics, we use perhaps other immunosuppressants going forward, which all potentially carries a risk of skin cancer,” Dr Ferguson underlined in his summary. But despite the markedly reduced risk of developing skin cancer, he reminded the audience that it is still important to carry on encouraging vitiligo patients to avoid getting burned and to use sun protection appropriately.

1. Ferguson J. Vitiligo is associated with a reduction in the incidence of melanoma and non-melanoma skin cancer: UK population-based cohort study. FC07.06, EADV Congress 2022, Milan, Italy, 7‒10 September.

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Posted on 5 November, 202225 March, 2024