Methotrexate may increased risk of skin cancer: Study

Every patient with skin cancer was compared with ten age and sex-matched controls.

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Last Updated on February 10, 2023 by The Health Master

Methotrexate may increased risk of skin cancer

Gothenburg: According to a recent study from the University of Gothenburg, the immunosuppressive medicine methotrexate (MTX) has been linked to an increased risk of three forms of skin cancer.

Patients using the medicine have moderate to severe psoriasis; nonetheless, a risk increase for basal cell carcinoma was only detected in this patient group.

The study, based on Danish health care registers, was a result of a research collaboration with the University of Southern Denmark, Aarhus University and the University of Copenhagen.

The scientists identified patients born in any of the Nordic countries who, between 2004 and 2018, were diagnosed with one of three types of skin cancer:

  • Basal cell carcinoma (BCC, 131,447 patients),
  • Squamous cell carcinoma (SCC, 18,661 patients),
  • Cutaneous malignant melanoma (CMM, 26,068 patients).

Every patient with skin cancer was compared with ten age and sex-matched controls.

Minor risk for individual

The results are published in the British Journal of Cancer, and the study shows that, at a group level, it was more common for patients who developed any of the three types of skin cancer, to have been treated with MTX previously.

This rise in risk is presented in the study as a range: 20-38% for BCC, 37-89% for SCC, and 13-61% for CMM.

The researchers also demonstrate that patients who had used higher doses of MTX were at higher risk for SCC and BCC. In contrast, no distinct dose-response relationship was observed for CMM.

Psoriasis shows different picture

When the researchers confined the study to patients with psoriasis, they found no statistical correlation linking MTX to a raised SCC or CMM risk. However, a rise in BCC risk remained.

“Patients with psoriasis probably have divergent sun exposure habits. Moreover, historically light therapy used to be a common treatment to treat psoriasis. Sun exposure habits and use of light therapies were examples of important factors we weren’t able to include in the study.”

Individual background factors weighed in

MTX is an often used and valuable immunosuppressive drug used to treat several inflammatory and autoimmune diseases.

Used since the 1950s, MTX still constitutes an important drug particularly in the dermatology and rheumatology treatment armamentarium, since it is mainly prescribed for patients with rheumatoid arthritis and psoriasis.

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