Abstract
Objectives: Cancer can cause mortality in systemic sclerosis (SSc). We investigated the association between cancer and SSc using the Clinical Practice Research Datalink (CPRD). Methods: A validated case-ascertainment strategy identified SSc patients in the CPRD. A cohort study design examined cancer occurrence following SSc, with SSc patients matched to six non-SSc comparators by age, sex and GP practice. Prevalent and incident cases of SSc were analysed separately. Descriptive statistics and Cox analyses determined hazard ratios for cancer occurrence. A case-control study (matched 1:6) examined cancer occurrence prior to SSc. Results: From 10.1 million individuals in CPRD, 1588 of cases of SSc were identified. Two hundred and six cancers followed SSc diagnosis (116 in prevalent and 90 in incident cohort). Commonest cancers were mucocutaneous (4.5%), lung (2.1%) and breast (1.9%). The proportion of SSc patients developing cancer was significantly higher than non-SSc in both incident (11.2% vs 9.7%, P ¼ 0.02) and prevalent cohorts (14.8% vs 12.1%, P ¼ 0.03); particularly for lung cancer (2.6% vs 0.9% in prevalent cohort, P < 0.001). Overall incidence of cancer in the SSc groups was 17.6/1000 person years, compared with 13.9/1000 person years in the non-SSc group. The adjusted hazard ratios for cancer were 1.41 (95% CI 1.14–1.75) and 1.32 (95% CI 1.04–1.67) for prevalent and incident SSc, respectively. No increased risk of cancer prior to SSc diagnosis was identified in the case-control study. Conclusion: We have identified an increased risk of cancer diagnosis following, but not before, SSc diagnosis. Our findings could support screening recommendations for cancer in SSc.
| Original language | English |
|---|---|
| Pages (from-to) | 1959–1965 |
| Number of pages | 7 |
| Journal | Rheumatology |
| Volume | 64 |
| Issue number | 4 |
| Early online date | 13 Aug 2024 |
| DOIs | |
| Publication status | Published - 30 Apr 2025 |
Data Availability Statement
This study is based in part on data from the Clinical Practice Research Datalink obtained under licence from the UK Medicines and Healthcare products Regulatory Agency. The data is provided by patients and collected by the NHS as part of their care and support. The interpretation and conclusions contained in this study are those of the author/second alone.Acknowledgements
The authors wish to thank Mrs Julia Snowball for her support with CPRD data extraction and data cleaning.Funding
This work was funded with matched funding from Scleroderma Raynaud’s UK and the Bath Institute for Rheumatic Diseases. Disclosure statement: J.D.P. has received speaker honoraria and undertaken consultancy work for Janssen Pharmaceuticals outside the submitted work. J.D.P. has undertaken consultancy work for Boehringer-Ingelheim, Permeatus Inc., Astra Zenaca, IsoMab and Sojournix Pharma, all outside the submitted work. No other author reports any disclosures relevant to the content of this work.
| Funders | Funder number |
|---|---|
| Scleroderma and Raynaud's UK | |
| Bath Institute For Rheumatic Diseases |
Keywords
- Raynaud’s phenomenon
- cancer
- epidemiology
- incidence
- mortality
- prevalence
- smoking
- systemic sclerosis
ASJC Scopus subject areas
- Rheumatology
- Pharmacology (medical)
