Association between pemphigus and subsequent malignancy: A nationwide population-based study in Taiwan.

Area of Science:

• Dermatology
• Oncology
• Epidemiology

Background:

• Pemphigus is a rare autoimmune disease targeting desmosomes.
• The cancer risk in non-paraneoplastic pemphigus is not well-established, especially in Asian populations.

Purpose of the Study:

• To investigate the risk of subsequent malignancies in pemphigus patients compared to controls in Taiwan.
• To analyze cancer risk stratified by sex and specific cancer types.

Main Methods:

• Retrospective cohort study using Taiwan's National Health Insurance Research Database (2000-2015).
• Included 357 pemphigus patients and 1,428 matched controls.
• Multivariable Cox regression adjusted for age, sex, and comorbidities (revised Charlson Comorbidity Index).

Main Results:

• No significant overall increase in cancer risk for pemphigus patients (aHR 1.103).
• Lymphatic and hematopoietic malignancies showed the highest risk association (aHR 2.903; p < 0.001).
• Males showed a higher initial risk, but sex was not an independent risk factor after adjustment.

Conclusions:

• Pemphigus is not linked to an overall increased risk of subsequent malignancy.
• Lymphatic and hematopoietic malignancies are most strongly associated with pemphigus.
• Sex is not an independent risk factor, though males had higher initial risk.