title: Predictors of malignancy development in patients with chronic pruritus.
abstract: BACKGROUND
  Patients with pruritus have been shown to have an increased incidence of certain subtypes of malignancy.
  
  
  OBJECTIVE
  To assess predictors of malignancy in patients with chronic pruritus without prior dermatologic diagnoses.
  
  
  METHODS
  Case-control study of 398 patients with chronic pruritus who developed a malignancy were compared with 8346 patients with chronic pruritus who did not develop a malignancy. Primary outcomes were odds of developing incident malignancy.
  
  
  RESULTS
  Age greater than 60 years (OR 4.04, 95% CI 3.08, 5.31), male sex (OR 1.39, 95% CI 1.13, 1.71) and liver disease (OR 2.37, 95% CI 1.00, 5.65) were predictors of malignancy development in patients with chronic pruritus and non-diseased skin. In an exploratory analysis with multiple imputation via chained equations, age greater than 60 years (OR 4.13, 95% CI 3.15, 5.42), male sex (OR 1.26, 95% CI 1.02, 1.55), and current or prior smoking (OR 2.02, 95% CI 1.42, 2.88) were predictors of malignancy development in patients with chronic pruritus and non-diseased skin.
  
  
  CONCLUSIONS
  Potential for misclassification and detection biases. Missing data.
  
  
  CONCLUSIONS
  In patients with chronic pruritus without concomitant dermatologic diagnoses, older age, male sex, liver disease and tobacco abuse increase the odds of an underlying malignancy.
authors.affiliation: Oregon Health and Science University, Portland, OR, United States. Electronic address: fett@ohsu.edu.
authors.forename: Nicole
authors.initials: N
authors.lastname: Fett
authors.affiliation: Department of Biostatistics and Epidemiology, Center for Clinical Epidemiology and Biostatistics, Center for Pharmacoepidermiology Research and Training, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, United States.
authors.forename: Kevin
authors.initials: K
authors.lastname: Haynes
authors.affiliation: Department of Biostatistics and Epidemiology, Center for Clinical Epidemiology and Biostatistics, Center for Pharmacoepidermiology Research and Training, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, United States.
authors.forename: Kathleen Joy
authors.initials: KJ
authors.lastname: Propert
authors.affiliation: Department of Dermatology, University of Pennsylvania School of Medicine, Philadelphia, PA, United States.
authors.forename: David J
authors.initials: DJ
authors.lastname: Margolis
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D002908:Chronic Disease; D015331:Cohort Studies; D055088:Early Detection of Cancer; D005260:Female; D006801:Humans; D015994:Incidence; D008107:Liver Diseases / Q000150:complications; D008297:Male; D008875:Middle Aged; D008954:Models, Biological; D009369:Neoplasms / Q000453:epidemiology* / Q000209:etiology; D011537:Pruritus / Q000150:complications*; D018570:Risk Assessment; D012737:Sex Factors; D012907:Smoking / Q000009:adverse effects; D006113:United Kingdom / Q000453:epidemiology
keywords: Itch; Malignancy risk factors; Medical dermatology; Pruritus; Pruritus as a sign of systemic disease; Screening for malignancy