Autoimmune Skin Diseases Linked to Better Cancer Survival: JAMA
A new study published in the Journal of American Medical Association showed that individuals with autoimmune skin diseases (ASDs) had significantly better cancer survival outcomes when compared to those without ASDs. The survival benefits were especially pronounced in patients with alopecia areata and Sjögren syndrome, and these advantages remained consistent across various cancer stages, treatment regimens, and comorbidity subgroups.
Although immune system dysregulation is a common feature of both cancer and autoimmune skin disorders, with cancer linked to immune evasion and ASDs to increased immunological activity, their effects on the prognosis of cancer are yet unknown. Thus, this study examined the relationship between ASDs and cancer prognosis as well as survival outcomes following antitumor therapy in cancer patients.
This population-based cohort study assessed survival outcomes for cancer patients who received antineoplastic treatment (chemotherapy, targeted therapy, or immunotherapy) between January 1, 2019, and June 30, 2021, using data from Taiwan's Nationwide Cancer Registry and National Health Insurance Database. Sjögren syndrome, vitiligo, psoriasis, cutaneous lupus erythematosus, lichen planus, autoimmune bullous disorders, systemic sclerosis, hidradenitis, morphea, dermatomyositis, and alopecia areata were taken as the main exposure criteria of ASDs.
During the follow-up period, the death rates from all causes and cancer were evaluated. Both propensity score matching and inverse probability of treatment weighting (IPTW) were used to adjust for any confounding. Hazard ratios (HRs) for all-cause mortality were estimated using Cox proportional hazards regression models, while subdistribution HRs (SHRs) for cancer-specific mortality were estimated using the Fine-Gray hazard model, where noncancer-related deaths were regarded as competing events.
26,008 of the 197,895 patients that were part of the study had ASD (mean [SD] age: 64.0 [13.3] years; 14,969 female [57.6%]), while 171 887 were in the non-ASD group (mean [SD] age: 62.8 [13.0] years; 80 525 female [46.9%]). With an IPTW-adjusted HR of 0.94 (95% CI, 0.92-0.96) for all-cause mortality and a SHR of 0.94 (95% CI, 0.92-0.96) for cancer-specific mortality, patients with ASDs fared considerably better than those without ASDs in terms of survival.
Propensity score-matched studies showed no change in these correlations. Sjögren syndrome and alopecia areata were consistently linked to a reduced risk of death all ASD subgroups. Overall, in this population-based cohort study, cancer survival results were noticeably higher for individuals with ASDs than for those without.
Source:
To, S.-Y., Lee, C.-H., Chen, Y.-H., Hsu, L.-F., Chen, I.-W., Yang, H.-W., Wen, Y.-L., & Kao, L.-T. (2025). Autoimmune skin diseases and survival outcomes after antineoplastic treatment in patients with cancer. JAMA Dermatology (Chicago, Ill.). https://doi.org/10.1001/jamadermatol.2025.1949
