Clinical Application of New Risk-Based Cancer Screening in Patients With Dermatomyositis

Dermatomyositis (DM) is an autoimmune disease of unknown etiology belonging to the family of idiopathic inflammatory myopathies (IIMs). The association of DM with cancer has long been established and there is increased prevalence of various cancers, including breast, ovarian, colorectal, lung, nasopharyngeal, and lung cancers. Cancers in IIMs are frequently diagnosed at later stages, making cancer the leading cause of death in adults with IIMs. Despite this increased prevalence of and worse prognosis associated with underlying cancer, screening recommendations for cancer detection in patients with IIM have been debated for many years, with wide variability in screening practices. This lack of clarity regarding ideal cancer screening practices became further complicated with the expanding knowledge of myositis-specific antibodies and their association with cancer risk, which raised the question of how to apply serology status to screening protocols. Finally, there has been a need to balance early cancer detection with avoidance of unnecessary screening procedures, given that cancer prevalence is best estimated at only 15% to 25% of patients with DM. Thus, applying screening to all patients is associated with many unnecessary procedures.

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Novembre 2024