Background/Purpose: Previous studies have shown an association between systemic sclerosis and cancer. However, because the disease is rare, large-scale studies are lacking, especially in Asians. We aimed to compare the incidence of cancer in patients with SSc and age- and sex-matched controls in a nationwide population-based cohort in Korea.

Methods: We included patients with SSc defined by the ICD-10 code (M34) and rare and intractable disease code (V138) and 1:5 age- and sex-matched controls using the Korean National Health Insurance Database. The outcomes of the study were incidence of cancer. Cox proportional hazard analysis and Kaplan-Meier curve were used to compare the incidence of cancer between patients with SSc and controls.

Results: A total of 5,145 patients with systemic sclerosis and 25,725 controls were included in the study. During the study period, the overall cancer incidence rate was 11.07 per 1,000 person-years in patients with systemic sclerosis and 7.59 per 1,000 person-years in controls. Overall cancer risk was 1.5 times higher in patients with systemic sclerosis (adjusted hazard ratio 1.46, 95% confidence interval 1.28–1.67). Lung cancer and lymphoma had a high risk in both male and female patients with systemic sclerosis, and colorectal cancer had a high risk only in male patients with systemic sclerosis. The risk of biliary cancer, skin cancer, and cervical cancer was high in female systemic sclerosis patients.

Conclusion: This nationwide cohort study showed that patients with systemic sclerosis were associated with increased cancer risk. Clinicians should be aware of cancers that may increase the risk in patients with systemic sclerosis and apply appropriate screening measures.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/increased-risk-of-cancer-in-patients-with-systemic-sclerosis-a-population-based-study/