BPO Not Linked with Higher Malignancy Risk: Meta-analysis
Key Takeaways
- A new meta-analysis indicates BPO use was not significantly associated with leukemia, AML, lymphoma, or any hematologic malignancy.
- The study included 4 studies and more than 4 million patients.
- Limitations included exposure misclassification and limited dose/duration data.
Benzoyl peroxide (BPO) use for acne vulgaris was not significantly associated with increased malignancy risk in a systematic review and meta-analysis of more than 4 million patients, accoriding to results from a new meta-analysis.
The review, published as a research letter in the Journal of Drugs in Dermatology, included 4 studies comprising 4,062,218 patients. Three studies reported baseline characteristics; among those patients, the mean age was 20.3 years, 64.1% were female, and 63.0% were White. Investigators searched PubMed, Embase, and Web of Science using PRISMA guidance and included human studies involving patients with acne vulgaris or BPO exposure and a defined comparator group without BPO exposure.
Leukemia risk was reported in all included studies. In pooled analysis, BPO use was not significantly associated with leukemia risk compared with nonuse (RR, 0.91; 95% CI, 0.68 to 1.21; P = 0.5; I² = 69.7%). Three studies evaluated acute myeloid leukemia and also found no significant association (RR, 0.98; 95% CI, 0.67 to 1.43; P = 0.9; I² = 77.3%).
Two studies reported lymphoma and any hematologic malignancy, and neither showed a statistically significant increase in risk, including lymphoma (RR, 0.99; 95% CI, 0.70 to 1.41; P = 0.9; I² = 79.0%) and any hematologic malignancy (RR, 0.99; 95% CI, 0.92 to 1.06; P = 0.7; I² = 0%). One study each reported internal malignancy and lung cancer, with no significant differences between BPO users and nonusers.
Cited limitations included potential exposure misclassification from prescription records or diagnostic codes and insufficient dosage, duration, and cumulative exposure data.
“Our findings suggest that the use of BPO for acne does not significantly increase the risk of benzene-related cancers,” the authors wrote.
Source: Lapenda I, et al. Journal of Drugs in Dermatology. 2026;25(5):9623.