Cancer Causes & Control

, Volume 6, Issue 1, pp 9–13 | Cite as

Cancer risk following polymyositis and dermatomyositis: a nationwide cohort study in Denmark

  • Wong-Ho Chow
  • Gloria Gridley
  • Lene Mellemkjær
  • Joseph K. McLaughlin
  • Jorgen H. Olsen
  • Joseph F. FraumeniJr.
Research Papers


Polymyositis and dermatomyositis (PM/DM) have been associated with cancer, although the long-term risks are poorly understood. To evaluate the risk of cancer by time periods subsequent to PM/DM diagnosis, a cohort of 539 patients hospitalized with PM/DM in Denmark between 1977 and 1989 was identified from the Danish Central Hospital Discharge Register. Cancer incidence among cohort members was ascertained by linkage to the Danish Cancer Registry using a unique personal-identification number. The overall cancer risk was elevated significantly among patients with DM (standardized incidence ratio [SIR]=3.8, 95 percent confidence interval [CI]=2.6–5.4) and to a lesser extent PM (SIR=1.7, CI=1.1–2.4). Significant excesses were observed for cancers of lung, ovary, and lymphatic and hematopoietic system. However, the excess cancer incidence declined steadily with increasing years since initial diagnosis of PM/DM. The cancer risk was increased about sixfold (SIR=5.9, CI=3.8–8.7) during the first year, but was lower during the second year (SIR=2.5, CI=1.1–4.8), with no significant excesses in subsequent years of follow-up. These findings confirm that PM/DM may occur as a paraneoplastic syndrome that calls for steps aimed at early cancer detection and treatment. Among long-term survivors of PM/DM, however, there is little evidence to warrant extensive preventive and screening measures beyond those recommended for the general population.

Key words

Cohort study Denmark dermatomyositis neoplasms polymyositis 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Plotz PH, Dalakas M, Leff RL, Love LA, Miller FW, Cronin ME. Current concepts in the idiopathic inflammatory myopathies: polymyositis, dermatomyositis, and related disorders. Ann Int Med 1989; 111: 143–57.Google Scholar
  2. 2.
    Bohan A, Peter JB, Bowman RL, Pearson CM. A computer-assisted analysis of 153 patients with polymyositis and dermatomyositis. Medicine (Baltimore) 1977; 56: 255–86.Google Scholar
  3. 3.
    Sigurgeirsson B, Lindelöf B, Edhag O, Allander E. Risk of cancer in patients with dermatomyositis or polymyositis: a population-based study. N Engl J Med 1992; 326: 363–7.Google Scholar
  4. 4.
    Bonnetblanc JM, Bernard P, Fayol J. Dermatomyositis and malignancy: a multicenter cooperative study. Dermatologica 1990; 180: 212–6.Google Scholar
  5. 5.
    Masi AT, Hochberg MC. Temporal association of polymyositis-dermatomyositis with malignancy: methodologic and clinical considerations. Mt Sinai J Med 1988; 55: 471–8.Google Scholar
  6. 6.
    Butler RC, Thompson JM, Keat ACS. Paraneoplastic rheumatic disorders: a review. J Roy Soc Med 1987; 80: 168–72.Google Scholar
  7. 7.
    Lakhanpal S, Bunch TW, Ilstrup DM, Melton LJIII. Polymyositis-dermatomyositis and malignant lesions: does an association exist? Mayo Clin Proc 1986; 61: 645–53.Google Scholar
  8. 8.
    Manchul LA, Jin A, Pritchard KI, et al. The frequency of malignant neoplasms in patients with polymyositis-dermatomyositis: a controlled study. Arch Intern Med 1985; 145: 1835–9.Google Scholar
  9. 9.
    Callen JP. The relationship of dermatomyositis/polymyositis to malignancy. J Rheumatol 1991; 18: 1645–6.Google Scholar
  10. 10.
    World Health Organization. International Classification of Diseases, Eighth Revision. Geneva, Switzerland: WHO, 1967.Google Scholar
  11. 11.
    Operations- og Behandlingsklassifikation. Copenhagen, Denmark: Danish National Board of Health, 1st ed. 1973, 2nd ed. 1980, 3rd ed. 1988.Google Scholar
  12. 12.
    Klassifikation of Sygdomme. Copenhagen, Denmark: Danish National Board of Health, 1976.Google Scholar
  13. 13.
    World Health Organization. International Classification of Diseases. Seventh Revision. Geneva, Switzerland: WHO, 1957.Google Scholar
  14. 14.
    Storm HH, Manders T, Friis S, Band S. Cancer Incidence in Denmark 1989. Copenhagen, Denmark: Danish Cancer Society, 1992.Google Scholar
  15. 15.
    Bailar JC, Ederer F. Significance factors for the ratio of a Poisson variable to its expectation. Biometrics 1964: 20: 639–43.Google Scholar
  16. 16.
    Barnes BE. Dermatomyositis and malignancy: a review of the literature. Ann Intern Med 1976; 84: 68–76.Google Scholar
  17. 17.
    Schulman P, Kerr LD, Spiera H. A reexamination of the relationship between myositis and malignancy. J Rheumatol 1991; 18: 1689–92.Google Scholar
  18. 18.
    Bernard P, Bonnetblanc P. Dermatomyositis and malignancy. J Invest Dermatol 1993; 100: 128s-32s.Google Scholar
  19. 19.
    Kinlen LJ. Immunosuppression and Cancer. Lyon, France: International Agency for Research on Cancer, 1992; IARC Sci. Pub. No. 116: 237–53.Google Scholar
  20. 20.
    Gridley G, Klippel JH, Hoover RN, Fraumeni JFJr. Incidence of cancer among men with the Felty syndrome. Ann Int Med 1994; 120: 35–9.Google Scholar
  21. 21.
    Gridley G, McLaughlin JK, Ekbom A, et al. Incidence of cancer among patients with rheumatoid arthritis. INCI 1993; 85: 307–11.Google Scholar
  22. 22.
    Storm HH, Clemmensen IH, Manders T, Brinton LA. Supravaginal uterine amputation in Denmark 1978–1988 and risk of cancer. Gynecol Oncol 1992; 45: 198–201.Google Scholar

Copyright information

© Rapid Communications of Oxford Ltd 1995

Authors and Affiliations

  • Wong-Ho Chow
  • Gloria Gridley
  • Lene Mellemkjær
  • Joseph K. McLaughlin
  • Jorgen H. Olsen
  • Joseph F. FraumeniJr.

There are no affiliations available

Personalised recommendations