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PUVA and cancer: a large-scale epidemiological study
B Lindelöf1, B Sigurgeirsson, E Tegner
1Department of Dermatology, Karolinska Hospital, Stockholm, Sweden.
Lancet (London, England)
|July 13, 1991
Summary
Psoralen and ultraviolet A radiation (PUVA) therapy for skin disorders may increase cancer risk. A Swedish study found a dose-dependent rise in squamous cell cancer, especially with over 200 treatments.
Area of Science:
- Dermatology
- Oncology
- Phototherapy Research
Background:
- Concerns exist regarding the long-term carcinogenic effects of psoralen and ultraviolet A radiation (PUVA) therapy.
- PUVA is a common treatment for various skin disorders.
Purpose of the Study:
- To investigate the association between PUVA therapy and the risk of developing specific cancers.
- To evaluate the dose-dependent relationship between PUVA treatment and cancer incidence.
Main Methods:
- A cohort study of 4799 Swedish patients treated with PUVA between 1974 and 1985.
- Analysis of cancer incidence in relation to the number of PUVA treatments received and patient demographics.
- Follow-up periods averaged 6.9 years for males and 7.2 years for females.
Main Results:
- A significant dose-dependent increase in the risk of squamous cell cancer of the skin was observed.
- Male patients receiving over 200 PUVA treatments showed a >30-fold increased incidence of squamous cell cancer compared to the general population.
- Elevated incidences of respiratory cancer (males and females), pancreatic cancer (males), and kidney and colonic cancer (females) were also noted (p < 0.05).
Conclusions:
- The study confirms a dose-dependent increase in squamous cell cancer incidence following PUVA therapy.
- PUVA therapy is associated with increased risks for several other cancer types, warranting further investigation and careful patient selection.
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