Five-year malignancy incidence in patients with chronic pruritus: A population-based cohort study aimed at limiting unnecessary screening practices - 14/03/14
Abstract |
Background |
The incidence of malignancy in patients with chronic pruritus and nondiseased skin is unknown.
Objective |
We sought to assess the hazard ratio (HR) of incident overall malignancy and incident malignancy by subtype in patients with chronic pruritus during the 5 years after diagnosis.
Methods |
A population-based cohort study was performed in the Health Improvement Network. In all, 8744 patients with chronic pruritus were matched with 31,580 patients without chronic pruritus based on sex, age, and practice. Primary outcomes were HR of incident malignancy and HR of malignancy subtypes.
Results |
The fully adjusted HR for incident malignancy in patients with chronic pruritus was 1.14 (95% confidence interval 0.98-1.33). The fully adjusted HR for incident hematologic malignancy and incident bile duct malignancy in patients with chronic pruritus was 2.02 (95% confidence interval 1.48-2.75) and 3.73 (95% confidence interval 1.55-8.97), respectively. The incidence of hematologic malignancy and cholangiocarcinoma in patients with chronic pruritus was 0.0016 and 0.0003 per person-year, respectively.
Limitations |
Potential for misclassification and detection biases is a limitation.
Conclusions |
Chronic pruritus without concomitant skin changes is a risk factor for having undiagnosed hematologic and bile duct malignancies, but not other malignancies. The overall incidence of these malignancies in patients with chronic pruritus is very low.
Le texte complet de cet article est disponible en PDF.Key words : chronic pruritus, generalized pruritus, itch, paraneoplastic signs, pruritus, skin signs of systemic disease
Abbreviations used : CI, HR, THIN
Plan
The project described was supported by the National Center for Research Resources and the National Center for Advancing Translational Sciences, National Institutes of Health (NIH), through Grant UL1TR000003. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH. |
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Conflicts of interest: None declared. |
Vol 70 - N° 4
P. 651-658 - avril 2014 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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