Use of immunomodulating drugs and risk of cutaneous melanoma: a nationwide nested case-control study
AuthorsBerge, L. A. M.
Andreassen, B. K.
Stenehjem, J. S.
Larsen, I. K.
Green, Adèle C
Veierød, M. B.
Robsahm, T. E.
AffiliationDepartment of Research, Cancer Registry of Norway, Oslo, Norway.
MetadataShow full item record
AbstractPurpose: Cutaneous melanoma is among the fastest growing malignancies in Norway and ultraviolet radiation (UVR) exposure is the primary environmental risk factor. Immunomodulating drugs can increase skin photosensitivity and suppress immune responses, and by such mechanisms influence melanoma risk. We, therefore, aimed to examine the associations between use of immunomodulating drugs and melanoma risk, at a nationwide population level. Patients and methods: In the Cancer Registry of Norway, we identified all cases aged 18-85 with a first primary cutaneous melanoma diagnosed in 2007-2015 (n=12,106). These were matched to population controls from the Norwegian National Registry 1:10 (n=118,564), on sex and year of birth using risk set sampling. Information on prescribed drugs (2004-2015) was obtained by linkage to the Norwegian Prescription Database (NorPD). Conditional logistic regression was used to estimate rate ratios (RRs) and 95% confidence intervals (CIs) for associations between use of immunomodulating drugs (immunosuppressants and corticosteroids) and melanoma risk, adjusted for ambient UVR and other drug use. Results: Compared with ≤1 prescription, use of ≥8 prescriptions of immunosuppressants was associated with increased risk of melanoma (RR 1.50, 95% CI 1.27, 1.77). Similar associations were found for subgroups of immunosuppressants: drugs typically prescribed to organ transplant recipients (OTRs) (RR 2.02, 95% CI 1.35, 3.03) and methotrexate (RR 1.27, 95% CI 1.04, 1.55). Similar results were found for high levels of cumulative doses and across all histological subtypes. Use of corticosteroids was not associated with melanoma risk. Conclusion: We found a positive association between use of immunosuppressants and melanoma risk, with the highest risk seen for drugs prescribed to OTRs. Knowledge about this risk increase is important for physicians and users of these drugs, for intensified surveillance, awareness and cautious sun exposure.
CitationBerge LAM, Andreassen BK, Stenehjem JS, Heir T, Karlstad O, Juzeniene A, et al. Use of Immunomodulating Drugs and Risk of Cutaneous Melanoma: A Nationwide Nested Case-Control Study. Clin Epidemiol. 2020;12:1389-401.
- Use of Antidepressants and Risk of Cutaneous Melanoma: A Prospective Registry-Based Case-Control Study.
- Authors: Berge LAM, Andreassen BK, Stenehjem JS, Heir T, Furu K, Juzeniene A, Roscher I, Larsen IK, Green AC, Veierød MB, Robsahm TE
- Issue date: 2020
- Cardiovascular, antidepressant and immunosuppressive drug use in relation to risk of cutaneous melanoma: a protocol for a prospective case-control study.
- Authors: Berge LAM, Andreassen BK, Stenehjem JS, Larsen IK, Furu K, Juzeniene A, Roscher I, Heir T, Green A, Veierød MB, Robsahm TE
- Issue date: 2019 Feb 20
- Ultraviolet radiation and risk of cutaneous melanoma and squamous cell carcinoma in males and females in the Norwegian Offshore Petroleum Workers cohort.
- Authors: Liu FC, Grimsrud TK, Veierød MB, Robsahm TE, Ghiasvand R, Babigumira R, Shala NK, Stenehjem JS
- Issue date: 2021 Jun
- Drugs with potential chemopreventive properties in relation to epithelial ovarian cancer--a nationwide case-control study.
- Authors: Baandrup L
- Issue date: 2015 Jul
- Use of nonsteroidal anti-inflammatory drugs and incidence of melanoma in the United States Radiologic Technologists study.
- Authors: Mai JZ, Kitahara CM, Sargen MR, Little MP, Alexander BH, Linet MS, Tucker MA, Cahoon EK
- Issue date: 2022 Jul 29