Topical calcineurin inhibitor (TCIs) use is not associated with cancer risk overall but is associated with a relatively small increased lymphoma risk, according to a review published in the May issue of JAMA Dermatology.

Megan Lam, from McMaster University in Hamilton, Ontario, Canada, and colleagues examined the correlation between TCI use and risk for malignant neoplasms in observational studies comparing treatment with TCIs and nonactive or active comparators. Data were included for eight cohort studies (408,366 treated participants, 1,764,313 nonactive comparator controls, and 1,067,280 controls using topical corticosteroids) and three unique case-control studies (3,898 cases and 14,026 cancer-free controls).

The researchers found that compared with nonactive comparators, there was no correlation between TCI use and cancer overall (relative risk, 1.03; 95 percent confidence interval, 0.92 to 1.16). The risk for lymphoma was elevated with TCI use compared with both nonactive comparators (relative risk, 1.86; 95 percent confidence interval, 1.39 to 2.49) and with topical corticosteroid comparators (relative risk, 1.35; 95 percent confidence interval, 1.13 to 1.61). TCI use was not associated with an increased risk for skin cancer (melanoma and keratinocyte carcinoma).

"Given that the absolute risk of lymphoma is low, particularly in children, the increase in relative risk translates to a very small increase in the absolute risk of lymphoma for a given patient," the authors write.

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