Risk of Cancer in Patients with Dermatomyositis or Polymyositis

Sigurgeirsson, Bárður; Lindelöf, Bernt; Edhag, O; Allander, Erik

doi:10.1056/nejm199202063260602

Cited by 726 publications

(428 citation statements)

References 16 publications

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“…Similar associations have been reported in other connective tissue diseases, in particular, dermatomyositis and polymyositis (15,16). Based on our findings, it is unlikely that the development of the 2 diseases together in the same patients is occurring simply by chance.…”

Section: Discussionsupporting

confidence: 90%

Cancer in systemic sclerosis

Abu‐Shakra

Guillemin

Lee

1993

Arthritis & Rheumatism

178

108

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Objective. To determine whether the frequency of cancer is increased among patients with systemic sclerosis (SSc).Methods. A retrospective chart review of 248 patients who were followed up prospectively was conducted.Results. Cancers developed in 18 patients (7.3%) during 2,001 patient-years at risk. The most frequent types were cancers of the lung (7 patients) and breast (5 patients). Older age at diagnosis of SSc was a significant risk factor for cancer. Lung cancer was associated with the presence of pulmonary fibrosis. The age-standardized incidence rate for all cancers (7.9/1,000) was 2.1 times the overall rate in the Ontario population (P < 0.0001).Conclusion. The frequency of cancer is increased in patients with SSc.Since the report of alveolar cell carcinoma occurring in patients with systemic sclerosis (SSc; scleroderma) (l), a number of studies have indicated possible associations between SSc and breast, gastro- intestinal, urogenital, and hematologic malignancies (2-5). Several cases of breast cancer were noted to occur in close temporal relationship to the onset of SSc, suggesting an etiopathologic association (2).Whether cancer occurs more frequently in patients with SSc than in the general population is uncertain. Previous reports have shown the frequency of cancer in these patients to be between 3% and 7% (3,5,6), but other studies have found either no malignancies or very low prevalence (6-8). Duncan and Winkelmann (5) found the frequency and types of cancer seen in their large series of scleroderma patients to be similar to that seen in the overall patient population at the Mayo Clinic (Rochester, MN). The results from most published reports, however, are difficult to interpret either because of small numbers of patients or because the studies lacked suitable control populations for reliable comparison. Roumm and Medsger (3) compared the occurrence of cancer in scleroderma patients from the Pittsburgh area with National Cancer Survey statistics and found a slight increase in frequency among the scleroderma patients after adjustment for age and sex.To help clarify this issue, we reviewed the health records of 248 patients with SSc who had been followed prospectively over a 1Cyear period, for the occurrence of cancer. The observed frequency was standardized for age and compared with the incidence of cancer in the province of Ontario. PATIENTS AND METHODSThe health records of 248 patients who attended the Scleroderma Clinic at the Wellesley Hospital between 1978 and 1992 and were being followed up as part of an ongoing

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Section: Discussionsupporting

confidence: 90%

Cancer in systemic sclerosis

Abu‐Shakra

Guillemin

Lee

1993

Arthritis & Rheumatism

178

108

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“…It should be noted that, although some of the risks found are large, they are based on small numbers of excess cases, and are the product of multiple tests of statistical significance. Nevertheless, other population-based studies have also found an increased risk for cancers of the lung, female genital organs and ovary among patients with DM (Sigurgeirsson et al, 1992;Airio et al, 1995;Chow et al, 1995). The results for PM and cancer are not as well supported: one study suggests that patients may be prone to certain tumours, such as lymphoma, myeloma or leukaemia due to a compromised immune state, or as a result of immuno-suppressive or cytotoxic therapy (Chow et al, 1995).…”

Section: Discussionmentioning

confidence: 98%

“…An increased incidence of cancer in patients with dermatomyositis (DM) (Hidano et al, 1992;Sigurgeirsson et al, 1992;Rose et al, 1994;Selvaag et al, 1994;Zantos et al, 1994;Airio et al, 1995;Chow et al, 1995;Maos et al, 1998) and polymyositis (PM) (Sigurgeirsson et al, 1992;Zantos et al, 1994;Chow et al, 1995;Maos et al, 1998) has been reported in many studies, though with wide variations in the estimated risks. A few studies did not find an excess risk of cancer (Lakhanpal et al, 1986;Manchul et al, 1998) although these were hospital-based case-control studies of limited size.…”

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confidence: 99%

Risk of cancer in patients with dermatomyositis or polymyositis and follow-up implications: a Scottish population-based cohort study

Stockton¹,

2001

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SummaryWe conducted a national, retrospective population-based cohort study of 705 patients hospitalized with a first diagnosis of dermatomyositis (DM) or polymyositis (PM) during 1982-1996 based on linkage of hospital discharge, cancer registration, and death records in Scotland. Risks of cancer were assessed by calculating standardized incidence ratios (SIR). A first malignancy was diagnosed concurrently or subsequently in 50 patients with DM (SIR 7.7, 95% CI 5.7-10.1), and 40 patients with PM (2.1, 1.5-2.9). Significantly elevated risks were observed for lung, cervix uteri, and ovarian cancer in patients with DM, and for Hodgkin's disease in patients with PM. The excess risk of cancer was highest around the time of diagnosis, and for patients with DM remained high for at least 2 years. Risks were elevated for both sexes but only significantly so for females, and were highest in patients aged 45-74 years at the time of diagnosis for DM and 15-44 for PM.

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“…There was no difference between the patients with polymyositis or dermatomyositis and either control group in the occurrence of neoplasms after an initial diagnosis of polymyositis or dermatomyositis. Sigurgeirsson et al, in a review of all known patients in Sweden diagnosed with polymyositis or dermatomyositis between 1969 and 1983, found increased risks of malignancy in patients with polymyositis and dermatomyositis (14). Among patients with polymyositis, the relative risk of cancer was 1.8 for males and 1.7 for females.…”

Section: Discussionmentioning

confidence: 99%

Inclusion body myositis and renal cell carcinoma. report of two cases and review of the literature

Ytterberg

Roelofs

Mahowald

1993

Arthritis & Rheumatism

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Objective. To describe the clinical course of 2 patients with concurrent inclusion body myositis and renal cell carcinoma and review published reports of inclusion body myositis associated with malignancy.Methods. Prospective followup of 2 patients. Review of published case reports and series of patients with inclusion body myositis.Results. Our 2 patients with inclusion body myositis and renal cell carcinoma had no improvement of strength following nephrectomy. Seven previously reported cases of inclusion body myositis and malignancy were identified and are discussed.Conclusion. Findings in our 2 patients suggest that there is no etiopathologic relationship between inclusion body myositis and malignancy.Inclusion body myositis is an inflammatory myopathy which resembles polymyositis clinically. The term inclusion body myositis was suggested by Yunis and Samaha in 1971, because of the characteristic histopathologic features of nuclear and cytoplasmic fibrillary inclusions in muscle fibers (1). These .-~~

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Risk of Cancer in Patients with Dermatomyositis or Polymyositis

Abstract: The risk of cancer is increased in patients with polymyositis or dermatomyositis. In patients with dermatomyositis there is also a higher rate of mortality from cancer.

Cited by 726 publications

References 16 publications

Cancer in systemic sclerosis

Cancer in systemic sclerosis

Risk of cancer in patients with dermatomyositis or polymyositis and follow-up implications: a Scottish population-based cohort study

Inclusion body myositis and renal cell carcinoma. report of two cases and review of the literature

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