Distinct Cancer Risk Profiles in Patients With Systemic Sclerosis With Autoantibody Stratification

Area of Science:

• Rheumatology
• Oncology
• Epidemiology

Background:

• Systemic sclerosis (SSc) is associated with an elevated cancer risk compared to the general population.
• Specific cancer patterns and their link to autoantibody status in SSc patients are not well understood.

Purpose of the Study:

• To evaluate cancer risk patterns in patients with systemic sclerosis.
• To investigate the association between specific autoantibodies and cancer development in SSc patients.

Main Methods:

• A multi-center cohort study analyzed 5-year cancer incidences in 66,637 SSc patients versus matched controls.
• Electronic medical records from 128 healthcare organizations (2014-2024) were used.
• Patients were stratified by autoantibody status (RNA polymerase III, anti-centromere, anti-Scl-70); Cox proportional hazards regression was applied.

Main Results:

• SSc patients showed a 17% increased all-type cancer risk (HR 1.17).
• Hematologic cancer risk was significantly elevated (HR 1.68), especially multiple myeloma (HR 2.13) and myelodysplastic syndromes (HR 2.03).
• Solid organ cancer risk increased (HR 1.23), with highest risks for esophageal (HR 3.96) and lung cancers (HR 2.32). Anti-Scl-70 positivity correlated with higher overall cancer risk, while RNA Polymerase III positivity was linked to hematologic cancers.

Conclusions:

• Systemic sclerosis patients face significantly higher risks for both hematologic and solid organ cancers.
• Cancer risk profiles in SSc vary based on autoantibody status.
• Findings support the need for targeted cancer screening strategies in SSc patients and further research.