John S Barbieri1, Shiyu Wang1, Alexis R Ogdie2, Daniel B Shin1, Junko Takeshita3. 1. Department of Dermatology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania. 2. Division of Rheumatology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania; Center for Clinical Epidemiology and Biostatistics, Department of Biostatistics, Epidemiology and Informatics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania. 3. Department of Dermatology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania; Center for Clinical Epidemiology and Biostatistics, Department of Biostatistics, Epidemiology and Informatics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania. Electronic address: junko.takeshita@pennmedicine.upenn.edu.
Abstract
BACKGROUND: Psoriasis is associated with increased risk of developing and dying from cancer. OBJECTIVE: To evaluate whether psoriasis patients who are prescribed biologics receive the recommended screening for cervical, breast, and colon cancer. METHODS: We conducted a retrospective cohort study using the Optum deidentified Electronic Health Record data set. Incidence rates for cervical, breast, and colon cancer screening were compared between psoriasis patients who were prescribed biologics and 2 matched comparator cohorts: general patient population and patients being managed for hypertension. Multivariable Cox proportional hazards regression was performed to assess for differences in the rates of cancer screening. RESULTS: Compared with those in the general population without psoriasis, psoriasis patients who were prescribed biologics had higher screening rates for cervical cancer (adjusted hazard ratio [aHR] 1.09; 95% confidence interval [CI] 1.02-1.16) and colon cancer (aHR 1.10; 95% CI 1.02-1.18). Compared with those with hypertension, patients with psoriasis who were prescribed biologics had lower screening rates for breast cancer (aHR 0.88; 95% CI 0.83-0.94) and colon cancer (aHR 0.89; 95% CI 0.83-0.95). CONCLUSIONS AND RELEVANCE: Patients with psoriasis who are prescribed biologic therapies may not be receiving adequate age-appropriate cancer screening, especially for breast and colon cancer.
BACKGROUND:Psoriasis is associated with increased risk of developing and dying from cancer. OBJECTIVE: To evaluate whether psoriasispatients who are prescribed biologics receive the recommended screening for cervical, breast, and colon cancer. METHODS: We conducted a retrospective cohort study using the Optum deidentified Electronic Health Record data set. Incidence rates for cervical, breast, and colon cancer screening were compared between psoriasispatients who were prescribed biologics and 2 matched comparator cohorts: general patient population and patients being managed for hypertension. Multivariable Cox proportional hazards regression was performed to assess for differences in the rates of cancer screening. RESULTS: Compared with those in the general population without psoriasis, psoriasispatients who were prescribed biologics had higher screening rates for cervical cancer (adjusted hazard ratio [aHR] 1.09; 95% confidence interval [CI] 1.02-1.16) and colon cancer (aHR 1.10; 95% CI 1.02-1.18). Compared with those with hypertension, patients with psoriasis who were prescribed biologics had lower screening rates for breast cancer (aHR 0.88; 95% CI 0.83-0.94) and colon cancer (aHR 0.89; 95% CI 0.83-0.95). CONCLUSIONS AND RELEVANCE: Patients with psoriasis who are prescribed biologic therapies may not be receiving adequate age-appropriate cancer screening, especially for breast and colon cancer.