Table 121Adjusted relative risk estimates for SCC at different levels of exposure to PUVA

ReferenceMultivariate adjusted risk estimate
Population ratesPerson counts
STERN1984A-Relative SMR (incident tumours after ≥22 months)
Medium:low(a)5.7 (2.4–13.9)
High:low(a)12.8 (5.8–28.5)
Note: if first SCC was detected after high PUVA dose, patients had a significantly higher mean number of tumours than those who developed SCC at low PUVA dose (3.4 vs 1.5; p <0.05)
STERN1994-RR (relative SMR)
Medium:low(a)2.6 (2.0–3.3)
High:low (a)5.9 (4.0–8.7)
STERN1998A-OR for first cancer after 1985(b)
Total PUVA exposures to 1985
<1001
100–1591.6 (0.9–3.1)
160–3364.5 (2.7–7.4)
≥3378.6 (4.9–15.2)
PUVA exposures after 1985
≥50 vs <501.4 (1.0–2.0)
MARCIL2001 (full cohort)IRR (tumour count unclear)
PUVA exposures to 1992 or first CSA use(c)
< 2001
≥ 2002.8 (2.6–3.2)
NIJSTEN2003AIRR (all tumours counted)HR (time to first tumour)
PUVA exposuresPUVA exposures
< 1001<1001
100–1993.20 (2.27–4.51)100–1992.38 (1.60–3.54)
200–2995.28 (3.38–8.25)200–3996.03 (4.09–8.88)
300–3998.18 (4.95–13.53)≥40010.75 (6.99–16.54)
400–49914.36 (7.97–25.87)
≥50018.67 (10.23–34.07)
LIM2005IRR-
PUVA exposures
<1001
100–1992.36 (1.51–3.68)
200–2994.14 (2.64–6.50)
300–3995.54 (3.38–9.09)
400–49911.05 (6.88–17.76)
≥50010.81 (6.76–17.29)
Genital tumours
STERN2002IRR (description of statistical methods unclear)-
High:low(a)2.8 (0.5–15.5)
a

Dose classification as high, medium or low was based on number of exposures and duration of treatment (i.e., a higher cumulative dose was required to classify as high dose at later follow-up times; see full classification table in Appendix Q)

b

The rate after 1985 was an arbitrary time-point chosen to investigate whether the risk changed at longer follow-up points

c

Cohort included those with follow-up interviews after 1992

From: 9, Phototherapy

Cover of Psoriasis
Psoriasis: Assessment and Management of Psoriasis.
NICE Clinical Guidelines, No. 153.
National Clinical Guideline Centre (UK).
Copyright © National Clinical Guideline Centre - October 2012.

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