Cancer Resources > Cancer News > 2002 > July

Carcinogenic effects of psoriasis treatment persists for many years

1990, most of the men had stopped PUVA treatment and those who continued treatment most likely received genital shielding, th

Last Updated: 2002-07-08 13:45:33 -0400 (Reuters Health)

NEW YORK (Reuters Health) - The increased risk of genital tumors associated with psoralen plus ultraviolet A (PUVA) for the treatment of psoriasis appears to persist long after the treatment has been stopped or genital shielding has been employed, according to a report in the July issue of the Journal of the American Academy of Dermatology.

Previous reports have shown that treatment with PUVA can increase the risk of penile and scrotal squamous cell carcinomas, the authors note. To address this problem, most institutions implemented genital shielding protocols in the 1980s. Also, the use of PUVA has decreased in the last two decades.

However, the current report shows that despite the increased use of genital shielding and a decrease in PUVA use, men first treated with PUVA in the mid-1970s demonstrate a higher than expected rate of genital tumors more than 15 years later.

Dr. Robert S. Stern and colleagues, from Beth Israel Deaconess Medical Center in Boston, assessed the outcomes of 892 men who were first treated with PUVA for psoriasis between 1975 and 1976. The current study period ran from May 1989 to November 1998.


Nearly 3% of patients developed genital tumors and close to half developed their first tumor after May 1989. In the last decade, the rate of genital tumors among men in the study cohort was about 53 times higher than expected in the general population. Men who had been exposed to high-doses of both PUVA and topical tar/ultraviolet B were at greatest risk for tumor development.

"Our findings suggest that the carcinogenic risks of PUVA are persistent after the treatment stops," the authors conclude. Long-term cancer surveillance is needed for PUVA-treated patients and it is probably prudent to reserve the therapy for only "severe and refractory cases of psoriasis," they add.

J Am Acad Dermatol 2002;47:33-39.

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