A LARGE nationwide cohort study has found that patients with Chronic lymphocytic leukaemia (CLL) face a substantially increased risk of developing skin cancer, alongside higher rates of metastasis and disease-specific mortality.
The Danish registry-based study followed 8,352 patients diagnosed with CLL between 1990 and 2020, alongside 41,760 matched individuals without the disease. Participants were tracked from the time of CLL diagnosis until skin cancer occurrence, death, emigration, or study end.
Increased Skin Cancer Risk in CLL
Over a 10-year period, the absolute risk of developing skin cancer was nearly doubled in patients with CLL compared with controls (13.5% vs 6.9%), corresponding to an absolute risk difference of 6.6 percentage points. The increased risk was observed across most skin cancer subtypes, with particularly notable elevations in basal cell carcinoma (8.6% vs 5.4%) and squamous cell carcinoma (4.7% vs 1.4%).
Importantly, the study also demonstrated that this elevated incidence translated into worse cancer-specific outcomes. Patients with CLL had a higher 10-year risk of skin cancer metastasis (0.7% vs 0.1%) and skin cancer–related death (0.3% vs 0.1%) compared with matched controls. Although these absolute risks remained relatively low, they were significantly higher than in the general population.
Immune Dysfunction May Underlie Findings
The findings support concerns that immune dysfunction associated with CLL, along with the effects of immunosuppressive treatments, may contribute to both increased cancer susceptibility and poorer outcomes following diagnosis. Despite this, the authors note that overall mortality in patients with CLL remained markedly higher than skin cancer–specific mortality, with more than half of patients (56.3%) dying from any cause during follow-up, compared with 39.3% of controls.
Implications for Screening and Surveillance
The authors conclude that patients with CLL represent a high-risk group for skin cancer and its complications. They highlight the need for increased awareness, preventive strategies, and potentially enhanced dermatological surveillance in this population to support earlier detection and improved outcomes.
Reference
Drejøe AMB et al. Risk of skin cancer among patients with chronic lymphocytic leukemia. JAMA Dermatol. 2026; DOI:10.1001/jamadermatol.2026.0355
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