Risk of Cancer in Patients with Hidradenitis Suppurativa: A Systematic Review and Meta-analysis

Hidradenitis suppurativa (HS) is a chronic, recurrent inflammatory skin disease. Emerging evidence suggests that the chronic systemic inflammation may predispose patients to an increased risk of malignancy. Despite this, information on cancer occurrence in patients with HS is scarce, and no meta-analysis has explored which types of cancer are more prevalent in patients with HS.

PubMed, Embase, and Web of Science were searched from inception until 7 March 2025 for studies investigating the risk of cancer in patients with HS compared with the general population. In addition, authors of unpublished studies (e.g., conference abstracts) were contacted for data retrieval. Studies had to report the number and/or risk of cancer overall or subtypes of cancer in patients with HS compared with the general population. Two independent authors conducted the screening and extracted data. The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines were followed. An inverse-variance-weighted random-effects meta-analysis was performed to calculate pooled odds ratio (ORs) and corresponding 95% confidence interval (CIs). The prespecified primary outcome was the risk of cancer overall and subtypes of cancer in patients with HS compared with the general population.

A total of 11 studies encompassing 624,721 patients with HS and 393,691,636 controls were included. Compared with controls, patients with HS had a significantly elevated risk of cancer overall (OR: 1.82; 95% CI 1.13-2.93; p = 0.018) and of gastrointestinal (OR: 1.61; 95% CI 1.29-2.01; p = 0.0002), head and neck (OR: 2.41; 95% CI 1.92-3.02; p = 0.00005), hematological (OR: 1.71; 95% CI 1.38-2.12; p = 0.00005), respiratory cancers (OR: 1.81; 95% CI 1.03-3.17; p = 0.04), Hodgkin lymphoma (OR: 2.44; 95% CI 1.55-3.85; p = 0.0001), and non-Hodgkin lymphoma (OR: 1.15; 95% CI 1.03-1.29; p = 0.01). Few studies reported estimates adjusted for ethnicity and environmental risk factors.

Having HS was associated with an increased risk of cancer overall, including several specific subtypes. Studies adjusting for confounders are highly warranted to assess the long-term association between HS and cancer.