A systematic review and meta-analysis to inform cancer screening guidelines in idiopathic inflammatory myopathies
Oldroyd, Alexander G. S. (Salford Royal NHS Foundation Trust (Salford, Regne Unit))
Allard, Andrew B. (Royal National Hospital for Rheumatic Diseases)
Callen, Jeffrey P. (University of Louisville)
Chinoy, Hector (Salford Royal NHS Foundation Trust (Salford, Regne Unit))
Chung, Lorinda (Palo Alto Health Care System)
Fiorentino, David (Stanford University)
George, Michael D. (University of Pennsylvania)
Gordon, Patrick (King's College Hospital NHS Foundation Trust)
Kolstad, Kate (Stanford University)
Kurtzman, Drew J. B. (Wright State University)
Machado, Pedro M. (London North West University Healthcare NHS Trust)
McHugh, Neil J. (University of Bath)
Postolova, Anna (Stanford Health Care)
Selva O'Callaghan, Albert (Hospital Universitari Vall d'Hebron)
Schmidt, Jens (Neuromuscular Centre)
Tansley, Sarah (Neuromuscular Centre)
Vleugels, Ruth Ann (Brigham and Women's Hospital (Boston, Estats Units d'Amèrica))
Werth, Victoria P. (Corporal Michael J. Crescenz VA Medical Center)
Aggarwal, Rohit (University of Pittsburgh)
Universitat Autònoma de Barcelona

Data:	2021
Resum:	To identify clinical factors associated with cancer risk in the idiopathic inflammatory myopathies (IIMs) and to systematically review the existing evidence related to cancer screening. A systematic literature search was carried out on Medline, Embase and Scopus. Cancer risk within the IIM population (i. e. not compared with the general population) was expressed as risk ratios (RR) for binary variables and weighted mean differences (WMD) for continuous variables. Evidence relating to cancer screening practices in the IIMs were synthesized via narrative review. Sixty-nine studies were included in the meta-analysis. DM subtype (RR 2. 21), older age (WMD 11. 19), male sex (RR 1. 53), dysphagia (RR 2. 09), cutaneous ulceration (RR 2. 73) and anti-transcriptional intermediary factor-1 gamma positivity (RR 4. 66) were identified as being associated with significantly increased risk of cancer. PM (RR 0. 49) and clinically amyopathic DM (RR 0. 44) subtypes, Raynaud's phenomenon (RR 0. 61), interstitial lung disease (RR 0. 49), very high serum creatine kinase (WMD -1189. 96) or lactate dehydrogenase (WMD -336. 52) levels, and anti-Jo1 (RR 0. 45) or anti-EJ (RR 0. 17) positivity were identified as being associated with significantly reduced risk of cancer. Nine studies relating to IIM-specific cancer screening were included. CT scanning of the thorax, abdomen and pelvis appeared to be effective in identifying underlying asymptomatic cancers. Cancer risk factors should be evaluated in patients with IIM for risk stratification. Screening evidence is limited but CT scanning could be useful. Prospective studies and consensus guidelines are needed to establish cancer screening strategies in IIM patients.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Myositis ; Muscle ; Autoantibodies ; CT scanning ; Neoplasia ; Epidemiology ; Meta-analysis
Publicat a:	Rheumatology, Vol. 60 (february 2021) , p. 2615-2628, ISSN 1462-0332

DOI: 10.1093/rheumatology/keab166
PMID: 33599244

14 p, 549.4 KB

El registre apareix a les col·leccions:
Articles > Articles de recerca
Articles > Articles publicats