Lichen Planus May Increase Oral Cancer Risk Up to 14-Fold and Genital Cancer Risk Up to 24-Fold: JAMA
Denmark: Patients with lichen planus may face an increased risk of developing oral, genital, and skin cancers, with the risk particularly pronounced when the inflammatory skin condition affects the corresponding anatomical site, according to a nationwide cohort study published in JAMA Dermatology.
The study, led by Cecilia Egede Medianfar from the Unit of Virus, Lifestyle and Genes at the Danish Cancer Institute, Copenhagen, Denmark, and colleagues, found that oral lichen planus was associated with a 9- to 14-fold higher risk of oral cancer, while genital lichen planus was linked to a 17- to 24-fold higher risk of genital cancer compared with the general population.
Lichen planus (LP) is an inflammatory disorder that can affect the skin and mucosal surfaces, including the mouth and genital region. Although previous research has suggested a possible association between LP and cancer, the extent of this risk across different anatomical sites remains uncertain.
To investigate this association, the researchers conducted a retrospective cohort study using nationwide Danish health registry data. They identified 35,845 individuals diagnosed with LP between 1978 and 2020, including 21,650 females and 14,195 males, with no history of cancer before diagnosis. Participants were followed until death, emigration, or December 31, 2023, to identify subsequent cancer diagnoses.
The researchers compared cancer incidence among patients with LP with that of the general Danish population, examining overall LP as well as oral, cutaneous and genital disease separately.
The study findings revealed the following:
- Higher oral cancer risk: Females with LP had increased risks of cancers of the lip, oral cavity and tongue, with standardized incidence ratios (SIRs) of 6.0, 7.5 and 6.8, respectively. The overall pattern was similar among male patients.
- Site-specific associations: Oral LP was associated with the highest risk of oral cancers, while genital LP showed the strongest association with cancers affecting the genital region.
- Increased skin cancer risk: The risk of cutaneous squamous cell carcinoma was modestly elevated among patients with LP (SIR, 1.4).
- Lower lung cancer risk: Females with LP had a lower incidence of lung cancer than the general population (SIR, 0.7).
- Low absolute cancer risk: Over 20 years, the absolute risk of oral cavity cancer was 0.8% in females and 1.0% in males, while genital cancer risks were 0.4% and 0.2%, respectively.
The researchers noted that the associations persisted over the follow-up period, highlighting the importance of considering site-specific cancer risks during long-term management of LP.
Although the relative risks were substantially elevated for certain cancers, the absolute risks remained low. The findings suggest that clinicians should remain alert to potential malignancy in patients with oral or genital LP, particularly at affected anatomical sites.
The study concluded that LP was associated with increased risks of oral and genital cancers and a modestly higher risk of skin cancer. Further research may help clarify the underlying mechanisms and inform appropriate long-term surveillance strategies.
Reference:
Medianfar CE, Kaderly Rasmussen EL, Baandrup L, et al. Cancer Risk in Patients With Overall and Site-Specific Lichen Planus. JAMA Dermatol. Published online October 14, 2026. doi:10.1001/jamadermatol.2026.3933
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