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The incidence and associations of malignancy in a large cohort of patients with biopsy-determined idiopathic inflammatory myositis

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Abstract

The South Australian (SA) myositis database has registered all patients with biopsy-proven inflammatory myositis in SA from 1980 to 2009. We determined the incidence and associations of malignancy in myositis by linking this database with the SA cancer registry. Standardized incidence ratios (SIR) for malignancy were determined using the total SA population over the same time period, stratified by age and gender. The SIR for cancer in the myositis population (n = 373) was 1.39, p = 0.047. There was a trend towards an increased SIR in dermatomyositis but no increased risk of malignancy in polymyositis or inclusion body myositis. Malignancies of the lung and prostate were the commonest and 28 % of malignancies occurred within one year of IIM diagnosis. The odds of developing cancer were significantly raised in the presence of a shawl sign, male gender, and in patients with overlap syndrome or rheumatoid arthritis whilst myalgia was a significant protective factor. HLA-A28 allele was overrepresented in patients with malignancy (11 vs 2 %, p = 0.006). Patients in SA with myositis are at modestly increased risk for malignancy. We report clinical and genetic risk factors allowing the identification of patients at greatest risk for malignancy.

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Acknowledgments

Vidya Limaye was the recipient of a grant from Arthritis Australia. The authors are grateful to Dr. Sally Cox for her assistance in establishing the South Australian myositis database.

Conflict of interest

The authors have no conflict of interest.

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Authors and Affiliations

  1. Department of Rheumatology, Royal Adelaide Hospital, North Terrace, Adelaide, SA, 5000, Australia

    Vidya Limaye

  2. Department of Medicine, University of Adelaide, Adelaide, SA, Australia

    Vidya Limaye

  3. Epidemiology Branch, South Australian Department of Health, Adelaide, SA, Australia

    Colin Luke

  4. Epidemiology Branch Health System Information and Performance Operations Division, SA Health, Adelaide, SA, Australia

    Graeme Tucker

  5. Department of Rheumatology, The Queen Elizabeth Hospital, Adelaide, SA, Australia

    Catherine Hill & Susan Lester

  6. Neuropathology Department, Hanson Institute, Institute of Medical and Veterinary Science, Frome Rd, Adelaide, SA, Australia

    Peter Blumbergs

  7. SA Pathology, Department of Health, Adelaide, SA, Australia

    Peter Roberts-Thomson

Authors
  1. Vidya Limaye
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  2. Colin Luke
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  4. Catherine Hill
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Correspondence to Vidya Limaye.

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Limaye, V., Luke, C., Tucker, G. et al. The incidence and associations of malignancy in a large cohort of patients with biopsy-determined idiopathic inflammatory myositis. Rheumatol Int 33, 965–971 (2013). https://doi.org/10.1007/s00296-012-2489-y

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  • DOI: https://doi.org/10.1007/s00296-012-2489-y

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