[2009] [THU0304] CANCER INCIDENCE IN SYSTEMIC SCLEROSIS IN SPAIN: RESULTS FROM A SINGLE UNIVERSITY HOSPITAL
B.E. Joven1, R. Fare1, F. Colina2, B. Ramos3, P.E. Carreira3 1Rheumatology; 2Pathology; 3Rheumathology, Hospital 12 de Octubre, Madrid, Spain
Background: An overall increase in the incidence of cancer in systemic sclerosis (SSc) has been described in some populations, but not confirmed in others.
Objectives: To analyze the incidence of cancer in a large series of Spanish SSc patients, followed in the same university hospital during the last 28 years, and to compare disease presentation in SSc patients with and without cancer.
Methods: Demographic, clinical and outcome data from all SSc patiens regularly followed in the rheumatology department were included in a data base created in 1989. Patients with cancer were selected from this database, and also through the pathology tumor registry in the hospital. Type of cancer, extension, temporal relationship with SSc, known risk factors for cancer development (family history, smoking habit, other toxics), cancer treatment and outcome, were obtained from the charts. Bivariate logistic regression, Chi square and t test were used to analyze differences between groups.
Results: From 275 SSc patients (86% females), 23 (18 females, 5 males) had any type of cancer: 8 breast, 2 lung, 2 colon, 1 urinary tract, 1 tiroides, 1 cerebral and 10 skin (1 melanoma, 8 basal cell carcinoma, 1 ductal carcinoma of the lip). Two patients with skin basal cell carcinoma had also other type of cancer. Five patients were smokers and 5 had family history of cancer. Mean age at cancer diagnosis was 59±13. At the moment of diagnosis, neoplasia was localized in 18 and metastatic in 5. Cancer treatments include surgery (21 cases), quimiotherapy (6) and radiotherapy (4). Cancer was considered cured in 19, and 3 patients died from the neoplasia. Seven patients had a cancer recidiva (2 basal cell, 1 urinary tract, 1 colon, 3 breast). Cancer was previous to SSc development in 8 (7±5 years before), coincidental with SSs (less than 12 months) in 2, and posterior in 13 (20±15 years after). Nine patients had diffuse SSc, 12 limited SSc and 2 SSc in overlap. ANA were positive in 86%, ACA in 40% and Scl70 in 13%. Patients with cancer tended to be older at the first SSc symptom (p=0.04), but there were not any other clinical differences between both groups, both considering the whole group of patients with cancer, or not considering patients with only skin basal cell carcinoma. The overall prevalence of cancer in our SSc patients group (8% considering all tumors, 6,2% not considering patients with only skin basal cell carcinoma) was higher than that obtained from the tumor registry in the area covered by the hospital (2,8%).
Conclusion: Cancer seems to be more prevalent in SSc patients in Spain than in the general population. Patients with cancer and SSc tend to be older at disease onset, but do not show other clinical or serological difference with SSc patients without cancer.
Disclosure of Interest: None declared
Ann Rheum Dis 2009;68(Suppl3):272
Scleroderma, myositis and related syndromes
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