411 Associations between immune-related diseases and skin cancer: An analysis of the diverse All of US research program

Although the immune system is known to play a significant role in skin cancer development, there are few studies evaluating associations between immune-related diseases and skin cancer, particularly in diverse populations. This study evaluated the relationship between immune-related diseases and basal cell carcinoma (BCC), cutaneous squamous cell carcinoma (SCC), and cutaneous melanoma (MM) diagnoses using the “All of Us” database, a United States study which prioritizes the inclusion of groups historically underrepresented in biomedical research. A cross-sectional analysis was conducted of Database Version 6, which contained 284,004 participants with electronic health record enrolled from May 2017-June 2022. Multivariate logistic regression analyses were adjusted for age, race/ethnicity, sex, smoking history, health insurance status, educational attainment, and history of photosensitivity. Analysis was conducted using R version 4.0.5. 6,531 participants with BCC diagnoses, 3,253 with SCC and 1,990 with MM were identified. Personal history of any immune-related disease was significantly associated with all skin cancer types (odds ratio and 95% confidence intervals - BCC:1.33[1.25-1.41]; SCC:1.42[1.31-1.53]; MM:1.72 [1.57-1.90]). Crohn’s disease, ulcerative colitis, hypothyroidism, type 1 diabetes, and rheumatoid arthritis were each significantly associated with the three types of skin cancer. Hyperthyroidism, Sjogren’s syndrome, systemic lupus, dermatomyositis/polymyositis, psoriasis, vitiligo, and multiple sclerosis were significantly associated with at least one skin cancer type, while scleroderma, atopic dermatitis, and alopecia areata were not associated with any. When evaluating non-White participants alone (n=111,111), history of any immune-related disease was similarly significantly associated with BCC and SCC. These results suggest that history of several immune-related diseases is associated with skin cancer and thus increased skin cancer surveillance in these patient populations may be indicated.