Malignancy screening in autoimmune myositis among Australian rheumatologists

The international literature advocates for cancer screening in newly diagnosed patients with autoimmune myositis; however, there is no widely accepted consensus or guideline to outline the optimal cancer screening strategy and the evidence is currently insufficient to support any recommendation.

Our study aimed to establish the current trends in practice in malignancy screening in autoimmune myositis among Australian rheumatologists.

All rheumatologists who were full members of the Australian Rheumatology Association in 2016 (386) were invited to complete an online questionnaire. Respondent demographics and information on screening approach and concerns were collected using multiple choice and open-response questions. There were 60 respondents (16% response rate). All available quantitative data were analysed and reported using statistical software. Qualitative data were analysed and grouped according to themes.

Most respondents (93%) performed cancer screening. Significant variation was found in terms of approach to patient selection, choice of screening test, delegation of screening and repeat screening. A lack of clinical practice consensus and guideline (77%), test selection knowledge (37%), knowledge on repeated screening (53%) and the potential for harm (62%) were identified challenges in this area.

Malignancy screening in autoimmune myositis was variable among this small cohort of Australian rheumatologists. The observed differences were driven by patient factors and clinician preferences. The group identified several challenges in the cancer screening process. Further research is warranted to address these challenges, close the evidence gap and develop workable guidelines.