Patients with hidradenitis suppurativa had 1.82 times the odds of developing cancer compared with the general population in a systematic review and meta-analysis.
Investigators included 11 studies involving 624,721 patients with hidradenitis suppurativa (HS) and 393.7 million controls. In organ-specific analyses, they showed elevated risks across multiple systems. For instance, the patients with HS had 2.41 times the odds of head and neck cancers, 1.81 times the odds of respiratory cancers, 1.71 times the odds of hematologic malignancies, and 1.61 times the odds of gastrointestinal cancer. In unadjusted analyses, lymphoma subtypes were also increased, including a 2.44 higher odds of Hodgkin lymphoma and 1.15 higher odds of non-Hodgkin lymphoma. The investigators noted that the overall risk remained low.
The analysis followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and used inverse-variance–weighted random-effects meta-analysis to pool odds ratios across heterogeneous studies. Data sources included PubMed, Embase, and Web of Science through March 7, 2025. Two independent reviewers conducted screening and data extraction, and effect estimates were standardized to odds ratios to allow cross-study comparison.
Several cancer types weren't associated with an increased risk in patients with HS, including bone, soft-tissue, breast, central nervous system, urogenital, and unspecified cancers. Analyses of individual skin cancer types didn't show statistically significant associations for basal-cell carcinoma, squamous-cell carcinoma, or melanoma based on pooled unadjusted estimates.
Adjusted estimates were available in four studies. In these analyses, lymphoma overall wasn't associated with an increased risk, and similar findings were observed for Hodgkin lymphoma, non-Hodgkin lymphoma, and cutaneous T-cell lymphoma, with a wide variation in estimates.
Study characteristics differed across the included reports, which were primarily conducted in the United States, with additional data from Europe and Korea. Reporting of potential confounders was limited. Body mass index wasn't reported, and data on smoking and ethnicity were inconsistently available. Reported smoking prevalence ranged from about 4% to 30% among patients with HS and from less than 1% to 7% in control populations.
Across the included studies, the variability in effect estimates was high, and a random-effects approach was applied to account for differences between the studies. The investigators indicated that the pooled results reflected general patterns rather than exact risk estimates.
Several limitations were identified. Adjustments for factors such as smoking, obesity, and alcohol use were limited; and information on disease severity and treatment was not available. Reporting of cancer subtypes was incomplete, and key variables such as body mass index and ethnicity were inconsistently documented.
The investigators suggested the associations may be multifactorial, noting potential contributions from inflammation and comorbid conditions
“Having HS was associated with an increased risk of cancer overall, including several specific subtypes, compared with controls,” wrote lead study author Daniel Isufi, of the Department of Dermatology and Allergy at Copenhagen University Hospital–Herlev and Gentofte Hospital at the University of Copenhagen and the Copenhagen Research Group for Inflammatory Skin at the Herlev and Gentofte Hospital in Denmark, and colleagues.
Co–study author Nikolai Loft reported receiving research funding from the Leo Foundation and speaker fees from Eli Lilly, Janssen Cilag, and Sandoz. Senior study author Rune Kjærsgaard Andersen reported research funding from the Leo Foundation and support from Eli Lilly for attendance at the 2022 Nordic Congress of DermatoVenerology. The study authors reported no other conflicts of interest.
Source: Dermatology and Therapy
