Abstract | OBJECTIVE: We previously reported a contemporaneous onset of cancer and scleroderma in patients with anti- RNA polymerase III antibodies, and we identified a biologic link between cancer and scleroderma. This investigation was designed to further evaluate whether autoantibody status and other characteristics are associated with cancer and a clustering of cancer with scleroderma onset. METHODS: Logistic regression analysis was performed to assess the relationship of 2 outcomes, cancer (model 1) and a short (±2 years) cancer-scleroderma interval (model 2), with autoantibody status and scleroderma covariates. RESULTS: Of 1,044 scleroderma patients, 168 (16.1%) had cancer. In the adjusted model 1, only older age at scleroderma onset (odds ratio 1.04 [95% confidence interval 1.02-1.05]) and white race (odds ratio 2.71 [95% confidence interval 1.22-6.04]) were significantly associated with an increased overall risk of cancer. In the adjusted model 2, only anti- RNA polymerase III positivity (odds ratio 5.08 [95% confidence interval 1.60-16.1]) and older age at scleroderma onset (odds ratio 1.04 [95% confidence interval 1.00-1.08]) were significantly associated with a short cancer-scleroderma interval. While anti- RNA polymerase III positivity was associated with a short cancer-scleroderma interval independent of age at scleroderma onset, the cancer-scleroderma interval shortened with older age at scleroderma onset in other antibody groups (Spearman's correlation P < 0.05), particularly among patients with anti-topoisomerase I antibodies and patients who were negative for anticentromere, anti- topoisomerase I, and anti- RNA polymerase III antibodies. CONCLUSION: Increased age at scleroderma onset is strongly associated with cancer risk overall. While anti- RNA polymerase III status is an independent marker of coincident cancer and scleroderma at any age, a clustering of cancer with scleroderma is also seen in patients with anti- topoisomerase I and other autoantibody specificities who develop scleroderma at older ages.
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Authors | Ami A Shah, Laura K Hummers, Livia Casciola-Rosen, Kala Visvanathan, Antony Rosen, Fredrick M Wigley |
Journal | Arthritis & rheumatology (Hoboken, N.J.)
(Arthritis Rheumatol)
Vol. 67
Issue 4
Pg. 1053-61
(Apr 2015)
ISSN: 2326-5205 [Electronic] United States |
PMID | 25605296
(Publication Type: Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)
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Copyright | Copyright © 2015 by the American College of Rheumatology. |
Chemical References |
- Autoantibodies
- RNA Polymerase III
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Topics |
- Adult
- Aged
- Autoantibodies
(blood)
- Female
- Humans
- Male
- Middle Aged
- Neoplasms
(blood, complications, immunology)
- RNA Polymerase III
(immunology)
- Risk Factors
- Scleroderma, Systemic
(blood, complications, immunology)
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