特发性炎症性肌病 (IIM) 患者患癌症的风险增加，但他们的癌症相关疾病负担仍不清楚。为了探讨癌症如何影响 IIM 患者的死亡率，并检查癌症和死亡的相关预后因素。我们发现1998 年至 2020 年间诊断的 IIM 患者，并通过与瑞典医疗保健和人口登记的联系确定了他们的癌症和死亡记录。使用灵活的参数方法在多状态模型中估计了从 IIM 诊断到癌症和死亡的转变风险。然后，我们根据 IIM 和粗略模型的癌症诊断预测了患癌症或死亡的概率，以及在给定时间的存活时间。我们还在多变量模型中探讨了进展为癌症和死亡的预后因素。 在 1826 名 IIM 患者中，310 名 (17%) 在 IIM 诊断前被诊断出患有癌症，306 名 (17%) 在 IIM 诊断后被诊断出患有癌症。在 IIM 后诊断为癌症的患者中，5 年因癌症和其他原因死亡的概率分别为 31% 和 18%，而 IIM 后未患癌症的患者的 5 年概率分别为 7% 和 15%。我们报告了与癌症进展和死亡风险相关的几个因素。具体来说，IIM 后首次患癌症的患者如果在 IIM 诊断时年龄较大、有癌症病史、皮肌炎并且在 IIM 后 1 年内被诊断出癌症，则面临更高的癌症特异性死亡率。我们观察到与之前相比，癌症死亡率大幅增加，而不是 IIM 后癌症诊断后的其他原因，表明 IIM 患者有效癌症管理的医疗需求尚未得到满足。这一发现以及已确定的预后因素为改善 IIM 患者癌症管理的未来研究方向提供了有用的见解。© 2024 作者。约翰·威利出版的《内科杂志》

Patients with idiopathic inflammatory myopathies (IIM) have an increased risk of cancer, but their cancer-related disease burden remains unclear.To explore how cancer might impact the mortality of patients with IIM and examine the associated prognostic factors for cancer and death.We identified patients with IIM diagnosed between 1998 and 2020 and ascertained their cancer and death records via linkage to the Swedish healthcare and population registers. Transition hazards from IIM diagnosis to cancer and death were estimated in multistate models using flexible parametric methods. We then predicted the probability of having cancer or death, and the duration of staying alive at a given time from IIM and cancer diagnoses from a crude model. We also explored prognostic factors for progression to cancer and death in a multivariable model.Of 1826 IIM patients, 310 (17%) were diagnosed with cancer before and 306 (17%) after IIM diagnosis. In patients diagnosed with cancer after IIM, the 5-year probability of death from cancer and from other causes was 31% and 18%, respectively, compared to 7% and 15% in patients without cancer after IIM. We reported several factors associated with risk of progression to cancer and death. Specifically, patients with first cancer after IIM who were older at IIM diagnosis, had cancer history, dermatomyositis and a cancer diagnosis within 1 year following IIM faced a greater cancer-specific mortality.We observed a substantial increase in mortality from cancer, compared to before, rather than other causes after a cancer diagnosis following IIM, suggesting an unmet medical need for effective cancer management in IIM patients. This finding, along with the identified prognostic factors, provides useful insight into future research directions for improving cancer management in IIM patients.© 2024 The Author(s). Journal of Internal Medicine published by John Wiley & Sons Ltd on behalf of Association for Publication of The Journal of Internal Medicine.