Association between itch and cancer in 16,925 pruritus patients: Experience at a tertiary care center

Publication date: Available online 11 September 2018

Source: Journal of the American Academy of Dermatology

Author(s): Valerie A. Larson, Olive Tang, Sonja Stander, Sewon Kang, Shawn G. Kwatra

Abstract

Background

Pruritus has been associated with cancer. However, limited data is available on the types of underlying malignancy associated with pruritus.

Objective

We sought to characterize the association between pruritus and different cancer types, as well as variations by racial group.

Methods

Cross-sectional study of patients ≥ 18 years old seen at the Johns Hopkins Health System from 2013-2017. Patients with pruritus were compared to patients without pruritus. Analyses were stratified by race.

Results

Patients with pruritus are more likely to have concomitant malignancy than those without pruritus (OR 5.76; 95% CI 5.53-6.00). Most strongly associated are cancers of the liver, gallbladder and biliary tract, hematopoietic system, and skin. Compared to whites, black patients more frequently have soft tissue, dermatological, and hematological malignancies, and less frequently have liver, respiratory, GI, and gynecological malignancies.

Limitations

Cross-sectional design precludes analysis of the temporal association between pruritus and malignancy. The study is limited to a single tertiary care center.

Conclusion

Pruritus is most strongly associated with cancers of the liver, skin, and hematopoietic system. Black patients with pruritus have a higher likelihood of skin, soft tissue, and hematological malignancies than whites, while whites have higher likelihood of liver, respiratory, GI, and gynecological malignancies.