NON Diffuse SSc, Peripheral Neuropathy, Concomitant Sjogren Syndrome and ANTI-RNA Polymerase III Represent Risk Factors for the Higher Frequency of Cancer in a Large Single Cohort of Patients with Systemic Sclerosis

Ana Paula Luppino-Assad¹, Adriana Bortoluzzo², Henrique Carriço da Silva³, Danieli Andrade⁴ and Percival Sampaio-Barros⁴, ¹Rheumatology, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, BR., sao paulo, Brazil, ²c Instituto Insper de Educação e Pesquisa, São Paulo, SP, Brasil, sao paulo, Brazil, ³Rheumatology, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, BR., SAO PAULO, Brazil, ⁴Rheumatology, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, BR., São Paulo, Brazil

Meeting: 2018 ACR/ARHP Annual Meeting

Keywords: Antibodies, Cancer, Malignancy, scleroderma and systemic sclerosis

Session Information

Date: Sunday, October 21, 2018

Title: Systemic Sclerosis and Related Disorders – Clinical Poster I

Session Type: ACR Poster Session A

Session Time: 9:00AM-11:00AM

Background/Purpose: A higher prevalence of cancer has been described in patients with systemic sclerosis (SSc), but the magnitude of this risk and the type of cancer vary among reports. Risk factors predisposing the development of malignancies in SSc patients are not well defined. The purpose of our study was to analyze the frequency and risk factors associated with cancer in a large single cohort of patients with SSc.

Methods: All cases of cancer diagnosed in a cohort of 662 patients classified as SSc according to the ACR/EULAR criteria, attended in a single referral scleroderma outpatient clinic in Brazil between 2010 and 2017, were reviewed and evaluated regarding demographic, clinical and laboratory features. We used the Brazilian National Cancer Institute database to compare the cancer prevalence in SSc patients with the expected rate of cancer in the general population, and to estimate the risk of each cancer in this group, pairing by age. Taking into account that all sample proportions have an observed incidence higher than the general population, the one-tail proportion test was used to compare the cancer incidence in the sample and the population. A logistic regression model was performed to find risk factors for cancer. Statistical significance was considered when p ≤ 0.05.

Results: ±± 13.91 years; p ≤±±±±±± 9.24 years; p = 0.029). When the frequency of cancer by gender in the SSc patients was compared with the predicted frequency of cancer in the Brazilian general population, it was found a significant association among female gender and cancer in general (p<0.001), as well as with breast (p<0.001), uterus (p=0.023), lung (p=0.013), colon (p=0.007), esophagus (p=0.012), stomach (p = 0.042), lymphoma/leukemia (p=0.007), thyroid (p=0.004) and melanoma (p=0.022); male gender was only associated with cancer in general (p=0.013). Multivariate logistic regression identified non diffuse SSc (OR 10.7, 95%CI 2.1-54.8, p=0.004), Sjogren syndrome (OR 3.4, 95%CI 1,4-8.5, p=0.007), peripheral neuropathy (OR 4.4, 95%CI 1.5-13.2, p=0.009) and anti-RNApolIII positivity (OR 5.1, 95%CI 1.2-22.7, p=0.032) as significant risk factors for cancer occurrence.

Conclusion: This study confirmed a higher frequency of cancer in a large SSc cohort and pointed out that non diffuse SSc, peripheral neuropathy, concomitant Sjogren syndrome and anti-RNA polymerase III positivity represent risk factors for the development of cancer in SSc.

Disclosure: A. P. Luppino-Assad, None; A. Bortoluzzo, None; H. C. da Silva, None; D. Andrade, None; P. Sampaio-Barros, None.

To cite this abstract in AMA style:

Luppino-Assad AP, Bortoluzzo A, da Silva HC, Andrade D, Sampaio-Barros P. NON Diffuse SSc, Peripheral Neuropathy, Concomitant Sjogren Syndrome and ANTI-RNA Polymerase III Represent Risk Factors for the Higher Frequency of Cancer in a Large Single Cohort of Patients with Systemic Sclerosis [abstract]. Arthritis Rheumatol. 2018; 70 (suppl 9). https://acrabstracts.org/abstract/non-diffuse-ssc-peripheral-neuropathy-concomitant-sjogren-syndrome-and-anti-rna-polymerase-iii-represent-risk-factors-for-the-higher-frequency-of-cancer-in-a-large-single-cohort-of-patients-with-sys/. Accessed .

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