Please use this identifier to cite or link to this item: https://hdl.handle.net/2440/121404
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Type: Journal article
Title: Level of UV exposure, skin type, and age are more important than thiopurine use for keratinocyte carcinoma development in IBD patients
Author: Wu, Y.
Ghaly, S.
Kerr, S.
Jackson, B.
Hanigan, K.
Martins, D.
Krishnaprasad, K.
Mountifield, R.E.
Whiteman, D.C.
Bampton, P.A.
Gearry, R.B.
Radford-Smith, G.L.
Lawrance, I.C.
Citation: Digestive Diseases and Sciences, 2020; 65(4):1172-1179
Publisher: Springer
Issue Date: 2020
ISSN: 0163-2116
1573-2568
Statement of
Responsibility: 
Yang Wu, Simon Ghaly, Stephen Kerr, Bryce Jackson, Katherine Hanigan ... Peter A. Bampton ... et al.
Abstract: BACKGROUND:Retrospective studies observe an increased risk of keratinocyte carcinomas (KCs) in patients with inflammatory bowel disease (IBD) on thiopurine (TP) medication. The role of traditional risk factors such as skin type and sun protection behavior has not been studied in this population. This study aimed to examine traditional KC risk factors and thiopurine use on skin cancer development in an IBD cohort. METHODS:Consecutive IBD patients were recruited from four specialist centers in Australia and New Zealand, each with varying UV exposure indices. Data pertaining to race, skin color, freckling and sun protection behavior, dose of TP therapy, and skin cancer development were elicited through a self-reported questionnaire. RESULTS:A total of 691 IBD patients were included with 62 reporting KC development. Thiopurine usage was similar among patients who developed skin cancer compared with those who did not (92% vs. 89%, p = 0.3). There was no statistically significant association between KC development and TP dose or 6-thioguanine nucleotide levels. In multivariate modeling, four factors were independently and significantly associated with KC: age over 61 years old versus less than 30 years old (OR 6.76; 95% CI 2.38-19.18), residing in Brisbane versus Christchurch (OR 3.3; 95% CI 1.6-6.8), never staying in the shade versus staying in the shade ≥ 50% of the time (OR 3.8; 95% CI 1.4-10.5), and having a skin type that never tanned versus other skin types (OR 6.9; 95% CI 2.9-16.0). CONCLUSION:Skin type, age, and sun protection behavior are more important risk factors for KC development than thiopurine medication use in this IBD population.
Keywords: Immunosuppression
Inflammatory bowel disease
Skin cancer
Rights: © Springer Science+Business Media, LLC, part of Springer Nature 2019
DOI: 10.1007/s10620-019-05818-w
Grant ID: http://purl.org/au-research/grants/nhmrc/1058522
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