Abstract
Although genetic studies have found an inverse relationship between vitiligo and skin cancer, epidemiological evidence is conflicting. We investigated the risk of skin cancer in adults with vitiligo using UK electronic primary care records from the Optimum Patient Care Research Database, 2010-2020. Vitiligo cases were age, sex, and GP-practice matched to population controls without vitiligo. Incidence of melanoma, nonmelanoma skin cancers (squamous cell carcinoma [SCC] and basal cell carcinoma [BCC]), and actinic keratoses (AK) was compared in vitiligo cases and controls using Cox regression. 15,156 vitiligo cases were matched to 60,615 controls. Vitiligo was associated with a 38% reduced risk of new-onset skin cancer (adjusted hazard ratio [aHR] 0.62 (95%CI 0.52-0.75), p<0.001), and all skin cancer subtypes: melanoma aHR 0.39 (95%CI 0.23-0.65), p<0.001; SCC aHR 0.67 (95%CI 0.49-0.90), p<0.01; BCC aHR 0.65 (95%CI 0.51-0.83), p<0.001. There was no significant association for AK (aHR 0.88, 95% CI 0.77, 1.01). People with vitiligo have a markedly reduced incidence of melanoma and non-melanoma skin cancer. Given concerns that some treatments, such as phototherapy, may increase skin cancer risk, this finding provides reassurance to people with vitiligo and clinicians managing the condition. (ClinicalTrials.gov identifier: NCT04969419).
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