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Methotrexate Linked to Increased Risk for Skin Cancer

When restricting analysis to patients with psoriasis, methotrexate was only associated with basal cell carcinoma

By Elana Gotkine (HealthDay News) | February 23, 2023

Methotrexate is associated with an increased risk for skin cancer, with evidence of a dose-response pattern, according to a study published online Feb. 4 in the British Journal of Cancer.

Sam Polesie, M.D., from the University of Gothenburg in Sweden, and colleagues examined the association between use of methotrexate and the risk for basal cell carcinoma (BCC), cutaneous squamous cell carcinoma (cSCC), and cutaneous malignant melanoma (CMM) in a nationwide Danish case-control study. Incident, histologically verified cases of BCC, cSCC, or CMM were identified from 2004 to 2018 (131,447; 18,661; and 26,068 cases, respectively). Ten controls were matched to each case on sex and birth year.

The researchers found that methotrexate use was associated with an increased risk for BCC, cSCC, and CMM, with adjusted odds ratios of 1.29 (95 percent confidence interval, 1.20 to 1.38), 1.61 (95 percent confidence interval, 1.37 to 1.89), and 1.35 (95 percent confidence interval, 1.13 to 1.61), respectively. Odds ratios increased with higher cumulative doses for BCC and cSCC. The corresponding odds ratios were 1.43 (95 percent confidence interval, 1.23 to 1.67), 1.18 (95 percent confidence interval, 0.80 to 1.74), and 1.15 (95 percent confidence interval, 0.77 to 1.72) when limiting the study population to patients with psoriasis.

"At present, our findings therefore cannot support that skin cancer risk should be an important consideration when prescribing methotrexate," the authors write. "However, our findings do deserve further attention for future investigations that would ideally include data on ultraviolet exposure."

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