Clinical and immunological features of patients with cancer-associated systemic sclerosis: An observational study

Introduction: Clinical and immunological features of patients with cancer-associated systemic sclerosis: an observational study. Objective: Several studies have reported an increased incidence of cancer in patients with systemic scle-rosis (SSc). The presence of RNA polymerase III antibodies (anti-RNA Pol 3) associates with an increased risk of cancer, but other risk factors need yet to be identified. We aimed to assess clinical and immuno-logical predictive factors of cancer-associated SSc to guide clinicians when setting up selective cancer screening.Methods: We conducted a monocentric, retrospective, observational study of SSc patients with and with-out associated malignancy. Clinical, laboratory and imaging data were collected, as well as SSc treatment. Subgroup analyses were performed according to the type of cancer and the time of diagnosis.Results: Of 464 SSc patients, 74 (16%) had cancer, with breast (n = 26) and lung cancer (n = 13) being the most frequent. Diagnosis of cancer was made less than 3 years before or after SSc diagnosis for 23 patients (31%). In a multivariate analysis, anti-RNA Pol 3 and anti-SSA antibodies were significantly associated with an increased overall risk of cancer with an odds ratio (OR) of 4.12 (95% CI [1.6-10.7]; P < 0.01) and 2.43 (95% CI [1.1-5.4]; P < 0.05), respectively. Age at diagnosis of SSc and delay from the SSc diagnosis were also independent risk factors of cancer. Interstitial lung disease and anti-topoisomerase antibodies were associated with an increased risk of lung cancer and cancer occuring more than three years after SSc diagnosis. Conclusion: In addition to anti-RNA Pol 3 antibodies, anti-SSA antibodies associated with an increased risk of cancer in SSc patients. Interstitial lung disease was a risk factor specifically for lung cancer and cancers diagnosed more than 3 years after SSc diagnosis. For these patients, a systematic and regular cancer screening should be considered.(c) 2023 Soci ete franc,aise de rhumatologie. Published by Elsevier Masson SAS. All rights reserved.