Cancer Risk Factors in Patients With Scleroderma

Examination of Autoantibody Status and Clinical Features Associated With Cancer Risk and Cancer-Associated Scleroderma

Shah AA, Hummers LK, Casciola-Rosen L, Visvanathan K, Rosen A, Wigley FM
Arthritis Rheumatol. 2015;67:1053-1061

Study Summary

In this analysis, Shah and colleagues examined a cohort of 1044 patients with scleroderma to identify factors that were associated with the presence of cancer and with a short cancer/scleroderma interval (±2 years) to provide insight on temporality. Among these participants, 168 (16.1%) had a diagnosis of cancer; the most prevalent types were breast (29.8%), skin including nonmelanoma (24.4%), lymphoma (7.7%), and lung (7.1%). Other cancers occurring in < 5% of participants were prostate, thyroid, colon, endometrial, and ovarian cancer.

In multivariable logistic regression, the clinical characteristics significantly associated with a diagnosis of cancer were age in years at onset of scleroderma (odds ratio [OR], 1.04; 95% confidence interval [CI], 1.02-1.05) and white race (OR, 2.71; 95% CI, 1.22-6.04). Autoantibody status, gender, smoking status, and cutaneous subtype of disease were not significantly associated with a diagnosis of cancer. In multivariable logistic regression evaluating predictors of a short cancer/scleroderma interval, anti-RNA polymerase III positivity (OR, 5.08; 95% CI, 1.60-16.1) and age in years at scleroderma onset (OR, 1.04; 95% CI, 1.00-1.08) were statistically significant.

Anticentromere positivity, anti-topoisomerase I positivity, white race, gender, smoking status, and cutaneous subtype of disease were not significantly associated with a short cancer/scleroderma interval. Furthermore, when the cancer/scleroderma interval was evaluated as a continuous variable, older age at scleroderma onset was significantly correlated with a shorter cancer/scleroderma interval, especially in participants who were positive for anti-topoisomerase I.

The authors concluded that increased age at scleroderma onset was strongly associated with cancer risk. In addition, anti-RNA polymerase III status was an independent predictor of a short cancer/scleroderma interval at any age, but particularly in patients with older age at scleroderma onset.

Cite this: Kevin Deane. Cancer Risk Factors in Patients With Scleroderma - Medscape - Jun 15, 2015.

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