IntroductionVitiligo, a chronic depigmenting disorder affecting 1-2% of the global
population, is caused by immune-mediated melanocyte destruction. While its pathogenesis
is multifactorial, the relationship between vitiligo and malignancy risk remains controversial.
Some studies suggest an increased cancer risk, while others propose a potential protective
effect, particularly against skin cancers. This study provides a comprehensive evaluation
of malignancy risks in patients with vitiligo.MethodsThis systematic review and meta-analysis
followed PRISMA 2020 guidelines and was registered with PROSPERO (CRD42023483130).
A comprehensive search was conducted across Medline, EMBASE, and Cochrane databases.
Studies reporting hazard ratios for malignancy incidence in patients with vitiligo
were included. Data extraction and risk of bias assessment were performed using the
Cochrane ROBINS-E tool.ResultsOf 7753 records identified, 6378 remained after duplicates
were removed, and 12 studies were included in the final review. Quantitative analysis
was performed on six studies. The combined sample comprised 3,267,951 participants,
including 289,322 patients with vitiligo. Three meta-analyses were conducted for melanoma,
non-melanoma skin cancer, and lymphoma. The pooled hazard ratio (HR) for lymphoma
was 1.00 (95% CI 0.40-2.53), for melanoma 0.80 (95% CI 0.27-2.34), and for non-melanoma
skin cancer 0.38 (95% CI 0.00-732.76), suggesting no consistent associations.ConclusionThis
meta-analysis did not identify significant differences in cancer risk across the examined
subgroups. While a protective effect of vitiligo against some malignancies cannot
be excluded, substantial heterogeneity among studies warrants cautious interpretation.
Further high-quality research is needed to clarify these associations.
