Malignancy in Systemic Sclerosis: A Multicenter Retrospective Study.

Area of Science:

• Rheumatology
• Oncology
• Epidemiology

Background:

• Systemic sclerosis (SSc) is linked to elevated cancer risk.
• Changes in SSc management necessitate re-evaluation of neoplasm risk.
• Understanding current malignancy prevalence and risk factors in SSc is crucial.

Purpose of the Study:

• To determine malignancy prevalence in the Hungarian SSc population.
• To identify risk factors associated with cancer in SSc patients.
• To compare findings with previous national and international SSc studies.

Main Methods:

• Retrospective data collection from 541 SSc patients across three Hungarian centers (2018-2024).
• Analysis of SSc characteristics, neoplasms, autoantibody profiles, treatments, and environmental factors.
• Statistical evaluation of risk factors including autoantibodies (anti-RNAPIII, ATA), SSc subtype (dcSSc), gender, smoking, and age.

Main Results:

• 85 out of 541 SSc patients had 96 registered tumors; skin cancer was most common (n=24), followed by breast and lung cancer.
• Tumor occurrence peaked around SSc diagnosis and 10 years later.
• Anti-RNAPIII positivity (OR 4.33) and ATA positivity (OR 2.34) were associated with higher tumor risk. Female gender, dcSSc, smoking, and older age were also risk factors. Cancer patients had significantly worse mortality (HR 4.75).

Conclusions:

• Malignancy significantly increases mortality in Systemic Sclerosis patients.
• Key risk factors for cancer in SSc include female gender, diffuse cutaneous SSc, anti-RNAPIII positivity, smoking, and older age.
• Regular dermatological cancer screening is recommended for all SSc patients.