2072: Results of an Integrated Program for Early Cancer Detection in Idiopathic Inflammatory Myopathies

Background/Purpose: Cancer risk is significantly increased in Idiopathic Inflammatory Myopathies (IIM), particularly within the first 3 to 5 years after diagnosis. Given that cancer represents the leading cause of mortality in IIM, implementing effective screening strategies is crucial for enabling early detection and timely intervention. This underscores the need to establish a comprehensive, multidisciplinary management program that incorporates risk-based cancer screening into routine care. Therefore, we aim to describe the model for the early detection of cancer in patients with IIM in our center’s multidisciplinary care program for patients with rheumatic diseases.

Methods: The Early Cancer Detection Program, initiated on March 1st, 2024, at the Rheumatology Clinic of Dr. Jose Eleuterio González University Hospital (Nuevo Leon, Mexico), targets patients over 18 with IIM. The program has three primary objectives:
a) Stratify cancer risk using a digital calculator based on international guidelines, categorizing patients as high, intermediate, or low risk.
b) Educate patients on the importance of screening, tailored to individual risk levels, including low-dose CT, FIT, mammography, cervical cytology, and PSA testing.
c) Identify prevalent cancers in IIM patients through screening; those with positive results are referred to oncology, while negative results are followed up individually.

Quality indicators include:

1. The proportion of patients screened by age and sex


2. The time from IIM diagnosis to completion of screening


3. The percentage of patients with positive screening results


4. The proportion of patients not screened

Data are presented with descriptive statistics, including frequencies, percentages, mean, standard deviation, median, and interquartile range.

Results: A total of 63 IIM patients were included (54 women, 9 men; mean age 45.9 ± 16.3 years). Most patients were at intermediate cancer risk (47.6%), followed by high risk (41.2%) and low risk (11.1%). All high-risk patients underwent at least one screening, with only five patients not completing any screening. The median time from IIM diagnosis to screening was 10.0 months (IQR: 2.0–12.0).

Men had a higher overall screening rate than women (Table 1). However, 67.6% of colon cancer screenings were performed in women over 40. Lung cancer screening was completed in 100% of men over 40, while 82.3% and 67.6% of women over 40 underwent breast and cervical cancer screenings, respectively.

Regarding screening results (Table 2), lung screening had positive findings in 6.3% of patients, but no neoplasms were diagnosed. One positive breast cancer screening confirmed adenocarcinoma, and one cervical screening found a high-grade squamous intraepithelial lesion.

Conclusion: Our findings reveal that most patients with IIM were classified as high or intermediate cancer risk, underscoring the clinical importance of risk stratification. Despite these insights, gaps in cancer screening highlight the urgent need for targeted education and intervention strategies. Additionally, multidisciplinary efforts and the implementation of personalized management plans are crucial for optimizing cancer prevention strategies.