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American Journal of Clinical Dermatology

Published in:

01-04-2015 | Systematic Review

Cancer Risk in Dermatomyositis: A Meta-Analysis of Cohort Studies

Authors: Jeannette M. Olazagasti, Pedro J. Baez, David A. Wetter, Floranne C. Ernste

Published in: American Journal of Clinical Dermatology | Issue 2/2015

Abstract

Background

An association between dermatomyositis (DM) and cancer has been reported since 1916; however, estimates of the associated risk vary widely. For cost-effectiveness reasons it might be important to elucidate the degree of overall cancer risk in DM.

Objective

The aim of this systematic review was to investigate the association of cancer in DM by performing a meta-analysis of cohort studies.

Data Sources

A systematic literature search of PubMed, Ovid MEDLINE, EMBASE, Web of Science, Scopus, and the Cochrane Collaboration was conducted without language restriction, to 1 May 2014.

Study Selection

Inclusion criteria included cohort studies assessing overall cancer risk in DM. Two reviewers independently performed the study selection. Inter-rater reliability for inclusion decisions was quantified using Cohen’s κ statistic. Disagreements were resolved by discussion.

Data Extraction and Synthesis

Desired variables were extracted from eligible studies independently by two investigators and disagreements were resolved by discussion. Quality of the selected studies was assessed using a modification of a recently employed system designed with reference to Meta-analysis Of Observational Studies in Epidemiology (MOOSE), Quality Assessment Tool for Systematic Reviews of Observational Studies (QATSO), and Strengthening the Reporting of Observational Studies in Epidemiology (STROBE). Summary estimates were derived using a random-effects model.

Main Outcome(s) and Measure(s)

Main outcome was the calculated relative risk of developing cancer after diagnosis of DM compared with the general population, estimated as the age- and sex-adjusted standardized incidence ratio (SIR). We hypothesized a priori that the relative risk would be higher in patients diagnosed with DM.

Results

A total of 1,272 articles were initially identified but only ten studies met the inclusion criteria. Selected studies included seven population-based and three hospital-based DM cohorts that ranged from 49 to 1,012 patients and had mean follow-up times from 3.7 to 10.4 years. The pooled SIR for the incidence of overall cancer in DM patients was 4.79 (95 % confidence interval 3.71–5.87) with significant heterogeneity (I ² = 85.8 %). However, the heterogeneity had no substantial influence on the pooled SIR for overall cancer in DM according to the sensitivity analysis.

Conclusions

Compared with the general population, DM patients are at a significantly increased risk for developing cancer. Understanding the magnitude of this risk is highly relevant toward assisting healthcare providers in clinical decision making, such as screening DM patients for cancer.

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Title: Cancer Risk in Dermatomyositis: A Meta-Analysis of Cohort Studies
Authors: Jeannette M. Olazagasti
Pedro J. Baez
David A. Wetter
Floranne C. Ernste
Publication date: 01-04-2015
Publisher: Springer International Publishing
Published in: American Journal of Clinical Dermatology / Issue 2/2015
Print ISSN: 1175-0561
Electronic ISSN: 1179-1888
DOI: https://doi.org/10.1007/s40257-015-0120-1

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Cancer Risk in Dermatomyositis: A Meta-Analysis of Cohort Studies

Abstract

Background

Objective

Data Sources

Study Selection

Data Extraction and Synthesis

Main Outcome(s) and Measure(s)

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Objective

Data Sources

Study Selection

Data Extraction and Synthesis

Main Outcome(s) and Measure(s)

Results

Conclusions

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