{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T15:27:04Z","timestamp":1792596424431,"version":"4.5.0"},"reference-count":34,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2023,7,7]],"date-time":"2023-07-07T00:00:00Z","timestamp":1688688000000},"content-version":"vor","delay-in-days":6,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100004319","name":"Pfizer, Inc.","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004319","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006920","name":"University of Pennsylvania","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006920","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,7,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Atopic dermatitis (AD) is associated with immunological dysfunction, which may influence cancer development. Previous studies of AD and cancer demonstrate inconsistent results and few of these studies examined children or AD severity and treatment.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>To determine malignancy risk among children and adults with AD.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We conducted a cohort study using electronic health records data from UK general practices in The Health Improvement Network between 1994 and 2015. Children (&amp;lt; 18\u2005years old) and adults (\u2265 18\u2005years old) with AD were matched on age, practice and index date to patients without AD. AD was categorized as mild, moderate or severe using treatments and dermatology referrals as proxies. The primary outcome was any incident malignancy, including in situ malignancy, identified using diagnosis codes and categorized into haematological, skin and solid organ malignancies. Secondary outcomes included specific malignancies: leukaemia, lymphoma, melanoma, nonmelanoma skin cancer (NMSC) and common solid-organ cancers.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Among 409 431 children with AD (93.2% mild, 5.5% moderate, 1.3% severe) and 1 809 029 children without AD who had median follow-up of 5\u20137\u2005years, the incidence rates of malignancy were 1.9\u20133.4 and 2.0 per 10 000 person-years (PY), respectively. The adjusted risk of malignancy overall did not differ with respect to AD [hazard ratio (HR) 1.02 (95% confidence interval 0.92\u20131.12)]. Severe AD was associated with increased lymphoma risk [HR 3.18 (1.41\u20137.16), excluding cutaneous T-cell lymphoma (CTCL)], and mild AD was associated with increased NMSC risk [1.55 (1.06\u20132.27)]. Among 625 083 adults with AD (65.7% mild, 31.4% moderate, 2.9% severe) and 2 678 888 adults without AD who had median follow-up of 5\u2005years, incidence rates of malignancy were 97.4\u2013125.3 per 10 000 PY and 103.7 per 10 000 PY, respectively. The adjusted risk of any malignancy did not differ with respect to AD [HR 1.00 (0.99\u20131.02)]. However, adults with severe AD had a twofold higher risk of non-CTCL lymphoma. AD was also associated with slightly higher skin cancer risk [HR 1.06 (1.04\u20131.08)] and slightly lower solid cancer risk [0.97 (0.96\u20130.98)] but results varied by specific cancers and AD severity.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Epidemiological evidence does not support a strong overall malignancy risk in AD but lymphoma risk may be increased with severe AD.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/bjd\/ljad072","type":"journal-article","created":{"date-parts":[[2023,7,7]],"date-time":"2023-07-07T18:08:13Z","timestamp":1688753293000},"page":"53-61","source":"Crossref","is-referenced-by-count":53,"title":["Malignancy risk in patients with atopic dermatitis: a population-based cohort study"],"prefix":"10.1093","volume":"189","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0189-0442","authenticated-orcid":false,"given":"Joy","family":"Wan","sequence":"first","affiliation":[{"name":"Department of Dermatology, Johns Hopkins University School of Medicine , Baltimore, MD , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4974-2561","authenticated-orcid":false,"given":"Daniel B","family":"Shin","sequence":"additional","affiliation":[{"name":"Departments of Dermatology"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7639-227X","authenticated-orcid":false,"given":"Maha N","family":"Syed","sequence":"additional","affiliation":[{"name":"Departments of Dermatology"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7736-6946","authenticated-orcid":false,"given":"Katrina","family":"Abuabara","sequence":"additional","affiliation":[{"name":"Department of Dermatology, University of California San Francisco , San Francisco, CA , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adina R","family":"Lemeshow","sequence":"additional","affiliation":[{"name":"Pfizer, Inc. , New York, NY , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0023-4176","authenticated-orcid":false,"given":"Zelma C Chiesa","family":"Fuxench","sequence":"additional","affiliation":[{"name":"Departments of Dermatology"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3480-2661","authenticated-orcid":false,"given":"Joel M","family":"Gelfand","sequence":"additional","affiliation":[{"name":"Departments of Dermatology"},{"name":"Biostatistics, Epidemiology and Informatics; University of Pennsylvania Perelman School of Medicine , Philadelphia, PA , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2023,7,7]]},"reference":[{"key":"2024031215233304300_ljad072-B1","doi-asserted-by":"crossref","first-page":"1251","DOI":"10.1016\/j.jaci.2009.10.009","article-title":"Global variations in prevalence of eczema symptoms in children from ISAAC phase three","volume":"124","author":"Odhiambo","year":"2009","journal-title":"J Allergy Clin Immunol"},{"key":"2024031215233304300_ljad072-B2","doi-asserted-by":"crossref","first-page":"1132","DOI":"10.1016\/j.jaci.2013.08.031","article-title":"Adult eczema prevalence and associations with asthma and other health and demographic factors: a US population-based study","volume":"132","author":"Silverberg","year":"2013","journal-title":"J Allergy Clin Immunol"},{"key":"2024031215233304300_ljad072-B3","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1016\/j.jid.2016.08.022","article-title":"Increasing comorbidities suggest that atopic dermatitis is a systemic disorder","volume":"137","author":"Brunner","year":"2017","journal-title":"J Invest Dermatol"},{"key":"2024031215233304300_ljad072-B4","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1111\/j.1600-065X.2011.01027.x","article-title":"Atopic dermatitis: a disease of altered skin barrier and immune dysregulation","volume":"242","author":"Boguniewicz","year":"2011","journal-title":"Immunol Rev"},{"key":"2024031215233304300_ljad072-B5","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1016\/j.gde.2008.01.003","article-title":"Pathways connecting inflammation and cancer","volume":"18","author":"Allavena","year":"2008","journal-title":"Curr Opin Genet Dev"},{"key":"2024031215233304300_ljad072-B6","doi-asserted-by":"crossref","first-page":"1123","DOI":"10.1001\/archderm.141.9.1123","article-title":"Incidence of cancer among patients with atopic dermatitis","volume":"141","author":"Hagstr\u00f6mer","year":"2005","journal-title":"Arch Dermatol"},{"key":"2024031215233304300_ljad072-B7","doi-asserted-by":"crossref","first-page":"1160","DOI":"10.1002\/ijc.26105","article-title":"Cancer risk in patients with allergic rhinitis, asthma and atopic dermatitis: a nationwide cohort study in Taiwan","volume":"130","author":"Hwang","year":"2012","journal-title":"Int J Cancer"},{"key":"2024031215233304300_ljad072-B8","doi-asserted-by":"crossref","first-page":"158","DOI":"10.1001\/jamadermatol.2019.3786","article-title":"Noncutaneous and cutaneous cancer risk in patients with atopic dermatitis: a systematic review and meta-analysis","volume":"156","author":"Wang","year":"2020","journal-title":"JAMA Dermatol"},{"key":"2024031215233304300_ljad072-B9","doi-asserted-by":"crossref","first-page":"174","DOI":"10.1159\/000076624","article-title":"Allergy and tumour outcome after primary cancer therapy","volume":"133","author":"Pompei","year":"2004","journal-title":"Int Arch Allergy Immunol"},{"key":"2024031215233304300_ljad072-B10","article-title":"Association between allergic conditions and colorectal cancer risk\/mortality: a meta-analysis of prospective studies","volume":"7","author":"Ma","year":"2017","journal-title":"Sci Rep"},{"key":"2024031215233304300_ljad072-B11","first-page":"251","article-title":"Generalisability of The Health Improvement Network (THIN) database: demographics, chronic disease prevalence and mortality rates","volume":"19","author":"Blak","year":"2011","journal-title":"Inform Primary Care"},{"key":"2024031215233304300_ljad072-B12","doi-asserted-by":"crossref","first-page":"1655","DOI":"10.1016\/j.jid.2017.03.029","article-title":"Development and validation of an algorithm to accurately identify atopic eczema patients in primary care electronic health records from the UK","volume":"137","author":"Abuabara","year":"2017","journal-title":"J Invest Dermatol"},{"key":"2024031215233304300_ljad072-B13","doi-asserted-by":"crossref","first-page":"393","DOI":"10.1002\/pds.1335","article-title":"Validation studies of The Health Improvement Network (THIN) database for pharmacoepidemiology research","volume":"16","author":"Lewis","year":"2007","journal-title":"Pharmacoepidemiol Drug Safety"},{"key":"2024031215233304300_ljad072-B14","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1046\/j.1365-2133.1998.02316.x","article-title":"Severity distribution of atopic dermatitis in the community and its relationship to secondary referral","volume":"139","author":"Emerson","year":"1998","journal-title":"Br J Dermatol"},{"key":"2024031215233304300_ljad072-B15","article-title":"Severe and predominantly active atopic eczema in adulthood and long term risk of cardiovascular disease: population based cohort study","volume":"361","author":"Silverwood","year":"2018","journal-title":"BMJ"},{"key":"2024031215233304300_ljad072-B16","doi-asserted-by":"crossref","first-page":"563","DOI":"10.1016\/j.jaci.2019.09.015","article-title":"Atopic eczema and fracture risk in adults: a population-based cohort study","volume":"145","author":"Lowe","year":"2020","journal-title":"J Allergy Clin Immunol"},{"key":"2024031215233304300_ljad072-B17","doi-asserted-by":"crossref","first-page":"1086","DOI":"10.1001\/jamadermatol.2020.1948","article-title":"Association between atopic eczema and cancer in England and Denmark","volume":"156","author":"Mansfield","year":"2020","journal-title":"JAMA Dermatol"},{"key":"2024031215233304300_ljad072-B18","first-page":"778","article-title":"The risk of malignancy associated with psoriasis","volume":"137","author":"Margolis","year":"2001","journal-title":"Arch Dermatol"},{"key":"2024031215233304300_ljad072-B19","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1186\/1471-2458-4-51","article-title":"Allergic conditions and risk of hematological malignancies in adults: a cohort study","volume":"4","author":"Soderberg","year":"2004","journal-title":"BMC Public Health"},{"key":"2024031215233304300_ljad072-B20","doi-asserted-by":"crossref","first-page":"808","DOI":"10.1038\/sj.jid.5700622","article-title":"Risk of lymphoma following exposure to calcineurin inhibitors and topical steroids in patients with atopic dermatitis","volume":"127","author":"Arellano","year":"2007","journal-title":"J Invest Dermatol"},{"key":"2024031215233304300_ljad072-B21","doi-asserted-by":"crossref","first-page":"1111","DOI":"10.1016\/j.jaci.2009.02.028","article-title":"Lymphoma among patients with atopic dermatitis and\/or treated with topical immunosuppressants in the United Kingdom","volume":"123","author":"Arellano","year":"2009","journal-title":"J Allergy Clin Immunol"},{"key":"2024031215233304300_ljad072-B22","doi-asserted-by":"crossref","first-page":"992","DOI":"10.1016\/j.jaad.2015.02.1116","article-title":"Risk of lymphoma in patients with atopic dermatitis and the role of topical treatment: a systematic review and meta-analysis","volume":"72","author":"Legendre","year":"2015","journal-title":"J Am Acad Dermatol"},{"key":"2024031215233304300_ljad072-B23","doi-asserted-by":"crossref","first-page":"893","DOI":"10.1016\/j.jaad.2021.03.016","article-title":"Real-world comorbidities of atopic dermatitis in the pediatric ambulatory population in the United States","volume":"85","author":"Huang","year":"2021","journal-title":"J Am Acad Dermatol"},{"key":"2024031215233304300_ljad072-B24","doi-asserted-by":"crossref","first-page":"549","DOI":"10.1001\/jamadermatol.2021.0345","article-title":"Association between topical calcineurin inhibitor use and risk of cancer, including lymphoma, keratinocyte carcinoma, and melanoma: a systematic review and meta-analysis","volume":"157","author":"Lam","year":"2021","journal-title":"JAMA Dermatol"},{"key":"2024031215233304300_ljad072-B25","doi-asserted-by":"crossref","first-page":"353","DOI":"10.1001\/jamadermatol.2018.4216","article-title":"Association between health maintenance practices and skin cancer risk as a possible source of detection bias","volume":"155","author":"Drucker","year":"2019","journal-title":"JAMA Dermatol"},{"key":"2024031215233304300_ljad072-B26","doi-asserted-by":"crossref","first-page":"1380","DOI":"10.1111\/bjd.12911","article-title":"Individuals with complete filaggrin deficiency may have an increased risk of squamous cell carcinoma","volume":"170","author":"Kaae","year":"2014","journal-title":"Br J Dermatol"},{"key":"2024031215233304300_ljad072-B27","doi-asserted-by":"crossref","first-page":"388","DOI":"10.1007\/s11692-014-9282-7","article-title":"Evidence that loss-of-function filaggrin gene mutations evolved in northern Europeans to favor intracutaneous vitamin D3 production","volume":"41","author":"Thyssen","year":"2014","journal-title":"Evol Biol"},{"key":"2024031215233304300_ljad072-B28","doi-asserted-by":"crossref","first-page":"280","DOI":"10.1016\/j.jaci.2012.12.668","article-title":"The multifunctional role of filaggrin in allergic skin disease","volume":"131","author":"McAleer","year":"2013","journal-title":"J Allergy Clin Immunol"},{"key":"2024031215233304300_ljad072-B29","doi-asserted-by":"crossref","first-page":"378","DOI":"10.1016\/j.anai.2010.03.003","article-title":"History of asthma or eczema and cancer risk among men: a population-based case\u2013control study in Montreal, Quebec, Canada","volume":"104","author":"El-Zein","year":"2010","journal-title":"Ann Allergy Asthma Immunol"},{"key":"2024031215233304300_ljad072-B30","first-page":"708","article-title":"Atopic dermatitis is not a protective factor for melanoma but asthma may be","volume":"19","author":"Hajdarbegovic","year":"2014","journal-title":"Int J Clin Oncol"},{"key":"2024031215233304300_ljad072-B31","doi-asserted-by":"crossref","DOI":"10.1111\/ijd.14595","article-title":"Fewer common melanocytic nevi in atopic vs. non-atopic dermatitis children in a birth cohort study","volume":"58","author":"Napolitano","year":"2019","journal-title":"Int J Dermatol"},{"key":"2024031215233304300_ljad072-B32","doi-asserted-by":"crossref","first-page":"1471","DOI":"10.1001\/archderm.140.12.1471","article-title":"Fewer melanocytic nevi found in children with active atopic dermatitis than in children without dermatitis","volume":"140","author":"Synnerstad","year":"2004","journal-title":"Arch Dermatol"},{"key":"2024031215233304300_ljad072-B33","doi-asserted-by":"crossref","first-page":"695","DOI":"10.1002\/ijc.21883","article-title":"Atopic diseases, immunoglobulin E and risk of cancer of the prostate, breast, lung and colorectum","volume":"119","author":"Wang","year":"2006","journal-title":"Int J Cancer"},{"key":"2024031215233304300_ljad072-B34","doi-asserted-by":"crossref","first-page":"445","DOI":"10.1111\/j.0022-202X.2005.23839.x","article-title":"The risk of cancer among patients previously hospitalized for atopic dermatitis","volume":"125","author":"Olesen","year":"2005","journal-title":"J Invest Dermatol"}],"container-title":["British Journal of Dermatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/bjd\/article-pdf\/189\/1\/53\/56947592\/ljad072.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/bjd\/article-pdf\/189\/1\/53\/56947592\/ljad072.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,3,12]],"date-time":"2024-03-12T20:36:55Z","timestamp":1710275815000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/bjd\/article\/189\/1\/53\/7221184"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,7]]},"references-count":34,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2023,7,7]]},"published-print":{"date-parts":[[2023,7,7]]}},"URL":"https:\/\/doi.org\/10.1093\/bjd\/ljad072","relation":{},"ISSN":["0007-0963","1365-2133"],"issn-type":[{"value":"0007-0963","type":"print"},{"value":"1365-2133","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2023,7]]},"published":{"date-parts":[[2023,7]]}}}