International Guideline for Idiopathic Inflammatory Myopathy-Associated Cancer Screening: an International Myositis Assessment and Clinical Studies Group (IMACS) initiative

Abstract

Adult-onset idiopathic inflammatory myopathy (IIM) is associated with an increased cancer risk within the 3 years preceding and following IIM onset. Evidence-and consensus-based recommendations for IIM-associated cancer screening can potentially improve outcomes. This International Guideline for IIM-Associated Cancer Screening provides recommendations addressing IIM-associated cancer risk stratification, cancer screening modalities and screening frequency. The international Expert Group formed a total of 18 recommendations via a modified Delphi approach using a series of online surveys. First, the recommendations enable an individual patient's IIM-associated cancer risk to be stratified into standard, moderate or high risk according to the IIM subtype, autoantibody status and clinical features. Second, the recommendations outline a 'basic' screening panel (including chest radiography and preliminary laboratory tests) and an 'enhanced' screening panel (including CT and tumour markers). Third, the recommendations advise on the timing and frequency of screening via basic and enhanced panels, according to risk status. The recommendations also advise consideration of upper or lower gastrointestinal endoscopy, nasoendoscopy and 18 F-FDG PET-CT scanning in specific patient populations. These recommendations are aimed at facilitating earlier IIM-associated cancer detection, especially in those who are at a high risk, thus potentially improving outcomes, including survival.Sections feedback on the acceptability of the final recommendations and co-authored the final manuscript, although they were not involved in the voting process (one patient partner chose to remain anonymous and not be included as a co-author).The project and final manuscript were reviewed and approved by the IMACS Scientific Committee.Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Diagnosing and characterizing inflammatory myopathies at an Australian tertiary public hospital: Resource utilization and direct healthcare costs

“…were excluded. The number and cost of pathology tests, radiology scans, neurophysiology, and other procedures that directly contributed to the diagnosis and/or characterization of IIM manifestations such as interstitial lung disease, arthritis, rash, cardiac involvement, and malignancy screening consistent with recently published guidelines, 12 were also recorded. Tests that were repeated for monitoring purposes (e.g., serial creatine kinase levels) were excluded.…”

Dermatomyositis: Practical Guidance and Unmet Needs

“…75 Newly published DM malignancy screening guidelines based on an International Myositis Assessment and Clinical Studies Group (IMACS) initiative represent a significant advancement towards evidence-based screening; however, much work, including demonstration of real-world utility, is still needed. 116 Arguably, the best current strategy for addressing malignancy screening in DM patients is to use shared decision-making strategies, which represents our approach. Shared decision-making takes into account patients' experiences, priorities, and goals to help them make informed decisions.…”

Strategies to enhance nasopharyngeal carcinoma screening in patients with adult‐onset idiopathic inflammatory myopathies

“…1 The International Myositis Assessment and Clinical Studies Group (IMACS) recently published the first evidence-based international guideline on IIM-associated cancer screening which attracted much attention. 2 The guideline stratified IIM patients into high, intermediate, and standard cancer risks using demographic, NPC is a neoplasm arising from the nasopharyngeal epithelium and is characterized by its distinct geographical variation in incidence. The annual incidence of NPC in Southeast Asia and Southern China was estimated to be 20 per 100 000 person-years (PYs), much higher than the reported incidence of less than 1 in 100 000 PYs in most of the world.…”