Risk Factors and Cancer Screening in Myositis

The idiopathic inflammatory myopathies, particularly dermatomyositis, are associated with an increased risk of cancer. Lung, ovarian, breast, colon, prostate, and cervical cancers, and hematologic malignancies, are among the most common associated cancers. Risk stratification for cancer in patients with myositis is based on clinical risk factors/red flags, myositis clinical subtypes, and myositis-specific autoantibodies. Clinical risk factors include older age at disease onset, male gender, dysphagia, acute onset/refractory myositis, cutaneous ulceration, necrosis/vasculitis, and elevated inflammatory markers. Appropriate screening strategies are based on the risk level. Further studies are warranted to determine the role of advanced imaging and comprehensive cancer screening.