Background
Methods
Study populations
Nationwide cohort n = 56,235 | Regional cohort n =8987 | |
---|---|---|
Cohort period | 2001–2012 | 2001–2013 |
Age at diagnosis (years) | ||
Mean (SD) | 60.1 (11.0) | 58.6 (11.2) |
Minimum–maximum | 20–80 | 23–80 |
Duration of follow-up (years) | ||
Median (IQR) | 5.1 (5.4) | 7.7 (4.3) |
Total no. of person-years at risk | 307,684 | 68,243 |
Cases of psoriasis | 599 | 150 |
Age at psoriasis diagnosis (SD) | 62.5 (10.0) | 63.6 (10.2) |
Psoriasis diagnoses
Genetic and lifestyle risk factors
Statistical analysis
Results
Risk of psoriasis in patients with breast cancer as compared to matched reference individuals
No. of PYs | Any psoriasis | Psoriasis vulgaris | Palmoplantar pustulosis | Arthropathic psoriasis | |||||
---|---|---|---|---|---|---|---|---|---|
Total/case no. | HR (95% CI) | Case no. | HR (95% CI) | Case no. | HR (95% CI) | Case no. | HR (95% CI) | ||
Overall | |||||||||
Matched reference cohort | 1,666,038 | 280,854/2795 | 1.00 (Ref.) | 1234 | 1.00 (Ref.) | 488 | 1.00 (Ref.) | 433 | 1.00 (Ref.) |
Breast cancer cohort | 307,684.8 | 56,235/599 |
1.17 (1.07–1.28)
| 298 |
1.33 (1.17–1.52)
| 95 | 1.04 (0.84–1.30) | 75 | 0.94 (0.73–1.20) |
Time since diagnosis | |||||||||
0 to < 0.5 year
| |||||||||
Matched reference cohort | 139,886.5 | 280,854/238 | 1.00 (Ref.) | 86 | 1.00 (Ref.) | 48 | 1.00 (Ref.) | 51 | 1.00 (Ref.) |
Breast cancer cohort | 27,780.35 | 56,235/50 | 1.08 (0.80–1.47) | 23 | 1.35 (0.85–2.14) | 13 | 1.40 (0.76–2.59) | 4 | 0.41 (0.15–1.13) |
0.5 to < 1 year
| |||||||||
Matched reference cohort | 138,587.1 | 278,473/228 | 1.00 (Ref.) | 113 | 1.00 (Ref.) | 27 | 1.00 (Ref.) | 32 | 1.00 (Ref.) |
Breast cancer cohort | 27,301.1 | 55,033/75 |
1.68 (1.30–2.19)
| 37 |
1.66 (1.15–2.41)
| 15 |
2.88 (1.52–5.43)
| 5 | 0.80 (0.31–2.07) |
1–5 years
| |||||||||
Matched reference cohort | 861,202.7 | 275,870/1451 | 1.00 (Ref.) | 629 | 1.00 (Ref.) | 281 | 1.00 (Ref.) | 219 | 1.00 (Ref.) |
Breast cancer cohort | 162,011.6 | 54,156/296 | 1.09 (0.96–1.24) | 146 |
1.27 (1.06–1.52)
| 43 | 0.81 (0.58–1.12) | 44 | 1.07 (0.77–1.48) |
> 5 years
| |||||||||
Matched reference cohort | 526,362 | 159,147/878 | 1.00 (Ref.) | 406 | 1.00 (Ref.) | 132 | 1.00 (Ref.) | 131 | 1.00 (Ref.) |
Breast cancer cohort | 90,591.81 | 28,430/178 | 1.17 (0.99–1.38) | 92 |
1.33 (1.06–1.68)
| 24 | 1.02 (0.66–1.60) | 22 | 0.98 (0.62–1.56) |
Age at breast cancer diagnosis | |||||||||
20–44 years
| |||||||||
Matched reference cohort | 158,527.2 | 25,361/185 | 1.00 (Ref.) | 75 | 1.00 (Ref.) | 30 | 1.00 (Ref.) | 46 | 1.00 (Ref.) |
Breast cancer cohort | 28,908.36 | 5099/43 | 1.35 (0.97–1.90) | 24 |
1.88 (1.17–3.00)
| 6 | 1.08 (0.45–2.62) | 6 | 0.82 (0.35–1.94) |
45–54 years
| |||||||||
Matched reference cohort | 389,187.5 | 61,404/707 | 1.00 (Ref.) | 285 | 1.00 (Ref.) | 155 | 1.00 (Ref.) | 122 | 1.00 (Ref.) |
Breast cancer cohort | 72,753.48 | 12,289/151 | 1.16 (0.97–1.38) | 72 |
1.39 (1.07–1.81)
| 28 | 0.95 (0.63–1.43) | 22 | 0.97 (0.61–1.53) |
55–64 years
| |||||||||
Matched reference cohort | 549,425.4 | 89,347/1067 | 1.00 (Ref.) | 447 | 1.00 (Ref.) | 213 | 1.00 (Ref.) | 172 | 1.00 (Ref.) |
Breast cancer cohort | 102,753.2 | 17,850/229 | 1.14 (0.99–1.32) | 109 |
1.27 (1.03–1.58)
| 42 | 1.04 (0.74–1.45) | 23 | 0.74 (0.47–1.15) |
65–80 years
| |||||||||
Matched reference cohort | 568,898.3 | 104,742/836 | 1.00 (Ref.) | 427 | 1.00 (Ref.) | 90 | 1.00 (Ref.) | 93 | 1.00 (Ref.) |
Breast cancer cohort | 103,269.8 | 20,997/176 | 1.16 (0.99–1.38) | 93 |
1.27 (1.01–1.59)
| 19 | 1.21 (0.73–2.01) | 24 | 1.30 (0.82–2.07) |
Risk of psoriasis by treatment, genetic predisposition, and lifestyle factors in patients with breast cancer
Total no. | No. of cases | HR (95% CI) | ||
---|---|---|---|---|
Model 1 | Model 2 | |||
Endocrine therapy | ||||
No | 1533 | 27 | 1.00 (Ref.) | 1.00 (Ref.) |
Yes | 7100 | 121 | 0.90 (0.59–1.36) | 0.80 (0.52–1.24) |
Chemotherapy | ||||
No | 5544 | 102 | 1.00 (Ref.) | 1.00 (Ref.) |
Yes | 3070 | 46 | 0.82 (0.57–1.19) | 0.70 (0.47–1.04) |
Radiotherapy | ||||
No | 2061 | 23 | 1.00 (Ref.) | 1.00 (Ref.) |
Yes | 6574 | 125 |
1.78 (1.14–2.78)
|
2.44 (1.44–4.12)
|
Surgery | ||||
Lumpectomy | 5203 | 94 | 1.00 (Ref.) | 1.00 (Ref.) |
Mastectomy | 3459 | 55 | 0.96 (0.69–1.34) |
1.54 (1.03–2.31)
|
Total no. | No. of cases | HR (95% CI) | ||
---|---|---|---|---|
Model 1 | Model 2 | |||
PRS score | ||||
Tertile 1 | 1440 | 13 | 1.00 (Ref.) | 1.00 (Ref.) |
Tertile 2 | 1442 | 36 |
2.74 (1.45–5.17)
|
2.83 (1.50–5.34)
|
Tertile 3 | 1483 | 40 |
2.94 (1.57–5.49)*
|
2.98 (1.59–5.58)*
|
BMI | ||||
< 25 kg/m2
| 2331 | 40 | 1.00 (Ref.) | 1.00 (Ref.) |
25–30 kg/m2
| 1434 | 28 | 1.18 (0.73–1.92) | 1.15 (0.71–1.87) |
> 30 kg/m2
| 536 | 19 |
2.29 (1.32–3.98)
|
2.10 (1.20–3.68)
|
Physical activity per week | ||||
0 h | 762 | 21 | 1.00 (Ref.) | 1.00 (Ref.) |
0–2 h | 1645 | 36 | 0.77 (0.45–1.33) | 0.77 (0.44–1.32) |
> 2 h | 1910 | 30 |
0.56 (0.32–0.98)
| 0.59 (0.33–1.03) |
Regular smoker (cigarette smoking >1 year) | ||||
No | 1773 | 26 | 1.00 (Ref.) | 1.00 (Ref.) |
Yes | 2546 | 62 |
1.65 (1.04–2.61)
|
1.59 (1.00–2.52)
|
Alcohol consumption | ||||
No | 104 | 2 | 1.00 (Ref.) | 1.00 (Ref.) |
Yes | 2861 | 58 | 1.03 (0.25–4.22) | 1.12 (0.27–4.70) |