Association Between Atopic Dermatitis and Colorectal Cancer Risk: A Korean Population-Based Study

Background/Objectives: Atopic dermatitis (AD) is a common chronic inflammatory skin disease that may influence cancer risk through immune dysregulation and chronic inflammation. The association between AD and colorectal cancer (CRC) remains unclear, with previous studies reporting conflicting results. Evidence from East Asian populations, where CRC incidence is rapidly rising, is particularly limited. Methods: We conducted a nested case-control study using the Korean National Health Insurance Service-National Sample Cohort (2002-2019). A total of 9920 incident CRC cases were identified and matched 1:4 with 39,680 controls by age, sex, income, and residential region. AD was defined using diagnostic codes and prescription records. Overlap propensity score weighting was applied to minimize confounding, and weighted logistic regression was used to estimate odds ratios (ORs) with 95% confidence intervals (CIs). Results: AD was not significantly associated with CRC risk (adjusted OR = 0.97, 95% CI: 0.91-1.04). The null association was consistent across subgroups stratified by age, sex, comorbidity burden, and allergic comorbidities. Sensitivity analyses yielded similar results. Conclusions: In this large, nationwide, population-based study, AD did not exhibit a significant connection with the risk of CRC. This null association remained consistent across multiple subgroups and sensitivity analyses, suggesting that AD may not play a substantial role in colorectal carcinogenesis. However, the observational design and lack of detailed lifestyle information may limit causal interpretation.