Patients with vitiligo see no significant increase in cancer risk

Key takeaways:

• Individuals with vitiligo showed similar cancer incidence rates per 100,000 person-years as matched controls.
• Reduced risks for melanoma, lung and bladder cancers were found.

Individuals with vitiligo did not display a significantly increased risk for cancer compared with the general population, according to a study.

“Traditionally linked to other autoimmune diseases, vitiligo is now recognized for its wider impact across various body systems, likely driven by shared immune mechanisms and inflammatory pathways,” Yochai Schonmann, MD, MSc, of the department of quality measures and research at Clalit Health Services in Tel Aviv, Israel, and colleagues wrote.

“While previous studies on vitiligo demonstrated multiple links between autoimmune diseases and cancer, current studies on vitiligo show diverse results. Even regarding melanoma and nonmelanoma skin cancers in patients with vitiligo, the literature reports mixed findings.”

Using Clalit Health Services’ database, Schonmann and colleagues conducted a population-based cohort study in which they calculated adjusted hazard ratios by multivariate Cox regression.

All patients entered into the database between 2000 and 2023 were included and each patient with a diagnosis of vitiligo (n = 25,008; mean age, 35.96 years; 50.7% male) was matched to up to 10 individuals without vitiligo (n = 245,550; mean age, 35.69 years; 50.71% male) for comparison.

Patients with vitiligo had 925 cancer cases compared with 8,215 cases in the controls, equating to crude incidence cancer rates of 499 per 100,000 person-years in those with vitiligo and 487 per 100,000 person-years in those without (adjusted HR = 1; 95% CI, 0.93-1.07).

After adjusting for sociodemographic and clinical covariates and sex, there remained no significant difference in cancer risk between the two groups.

When stratified by age, those with vitiligo between age 20 to 49 years had a cancer incidence rate of 299 per 100,000 person-years compared with 254 in the control group (aHR = 1.2; 95% CI, 1.04-1.38). In the age 0 to 19 years and older than age 50 years groups, the incidence rates were comparable between patients with vitiligo and controls.

Additionally, reduced risks for melanoma (aHR = 0.7; 95% CI, 0.5-0.99), lung cancer (aHR = 0.73; 95% CI, 0.57-0.93) and bladder cancer (aHR = 0.7; 95% CI 0.52-0.94) were found in those with vitiligo.

“Our study demonstrates that incidence rates of cancer are not increased in patients with vitiligo compared to healthy controls,” the authors wrote. “We suggest that routine cancer screening (eg, for breast, colorectal, etc) in patients with vitiligo should be conducted only according to the screening recommendations in the general population.”