Association Between Psoriasis and Prostate Cancer Risk in Men: A Retrospective Cohort Study.

Abstract

Objective: Psoriasis is a chronic immune-mediated inflammatory disease, but its association with prostate cancer remains unclear. This study evaluated the relationship between psoriasis and the risk of prostate cancer in men.

Methods: We conducted a retrospective cohort study using data from 2006 to 2023 within the TriNetX global federated research network. Male patients aged 50-84 years with psoriasis were identified and propensity score-matched 1:1 to controls without psoriasis based on age and relevant clinical characteristics. A 2-year lag period was applied to reduce reverse causation. Hazard ratios (HRs), 95% confidence intervals (CIs), and cumulative incidence were estimated using the TriNetX "Compare Outcomes" module.

Results: After matching and lag exclusion, 127,630 patients with psoriasis and 128,309 controls were included. Over a maximum follow-up of 6 years, 1,243 cases of prostate cancer occurred in the psoriasis group and 521 in controls, corresponding to cumulative incidences of 0.974% and 0.406%, respectively (absolute risk difference, 0.568%). Psoriasis was associated with a significantly increased risk of prostate cancer compared with controls (HR 2.09; 95% CI, 1.89-2.32).

Conclusion: Psoriasis was associated with an increased relative risk of prostate cancer; however, the absolute risk difference was small. These findings suggest a potential link between systemic inflammation and prostate cancer but may have limited immediate clinical implications and are unlikely to warrant changes in current clinical practice. Given the observational design, causal inference cannot be established, and further studies are warranted to clarify underlying mechanisms and clinical relevance.