{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T02:25:29Z","timestamp":1787192729478,"version":"build-2736575974"},"reference-count":24,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T00:00:00Z","timestamp":1785801600000},"content-version":"vor","delay-in-days":215,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Wellcome Trust Early Career Award","award":["316390\/Z\/24\/Z"],"award-info":[{"award-number":["316390\/Z\/24\/Z"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,6,15]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Cardiovascular events (CVEs) and malignancy are important non-disease-related causes of mortality in SSc. We evaluated secondary care utilisation and impact of deprivation on comorbidity patterns in SSc in England.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We analysed secondary care service utilisation in SSc using Hospital Episode Statistics for England for 2024. Cases were linked to Index of Multiple Deprivation deciles. Myocardial infarction (MI), lung cancer, breast cancer, melanoma rates and short-term all-cause mortality were explored, alongside comparisons with SLE and RA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In 2024, \u22486000 people with SSc (84.6% female, 70.8% between 51 and 80\u2009years of age, 73.3% White ethnicity) accessed secondary healthcare in England. Older SSc patients were overrepresented in less-deprived postcodes (P\u2009&amp;lt;\u20090.001). MI, lung cancer, breast cancer and melanoma were more common in SSc compared with unmatched estimates in the general population. Lung cancer was more frequent among less-deprived patients (P\u2009&amp;lt;\u20090.001). The all-cause mortality attrition rate was \u22483% in SSc over 3\u2009months (30.8% with lung cancer and &amp;gt;60% with melanoma). Rates of breast cancer were higher in SSc compared with SLE (P\u2009=\u20090.014) and RA (P\u2009=\u20090.012). There was a higher rate of lung cancer in SSc compared with SLE (P\u2009&amp;lt;\u20090.001). Melanoma rates were similar across diseases (\u22480.2%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Secondary care utilisation in SSc suggests less deprived SSc patients are older. All-cause mortality is higher in SSc patients receiving cancer care. Cancer occurrence is higher in SSc compared with SLE and RA. Our findings might support healthcare services planning and cancer screening for SSc in England.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/rap\/rkag094","type":"journal-article","created":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T11:23:43Z","timestamp":1785756223000},"source":"Crossref","is-referenced-by-count":0,"title":["Impact of social deprivation on cancer occurrence and cardiovascular events in systemic sclerosis"],"prefix":"10.1093","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-1443-9320","authenticated-orcid":false,"given":"Amy","family":"Turnbull","sequence":"first","affiliation":[{"name":"Bristol Medical School, University of Bristol , Bristol,","place":["UK"]},{"name":"Department of Internal Medicine, Bristol Royal Infirmary, University Hospitals Bristol and Weston NHS Foundation Trust , Bristol,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0781-2752","authenticated-orcid":false,"given":"Ula","family":"Tymoszuk","sequence":"additional","affiliation":[{"name":"Scleroderma and Raynaud\u2019s UK , London,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2884-1998","authenticated-orcid":false,"given":"Fiona A","family":"Pearce","sequence":"additional","affiliation":[{"name":"Lifespan and Population Health, School of Medicine, University of Nottingham , Nottingham,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4102-0190","authenticated-orcid":false,"given":"Benjamin G","family":"Faber","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, North Bristol NHS Trust , Bristol,","place":["UK"]},{"name":"Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, University of Bristol , Bristol,","place":["UK"]},{"name":"MRC Integrative Epidemiology Unit, University of Bristol , Bristol,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3067-7349","authenticated-orcid":false,"given":"Shaney L","family":"Barratt","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, North Bristol NHS Trust , Bristol,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sue","family":"Farrington","sequence":"additional","affiliation":[{"name":"Scleroderma and Raynaud\u2019s UK , London,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nick","family":"Jeffries-Owen","sequence":"additional","affiliation":[{"name":"Scleroderma and Raynaud\u2019s UK , London,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1139-2009","authenticated-orcid":false,"given":"Ami A","family":"Shah","sequence":"additional","affiliation":[{"name":"Division of Rheumatology, Johns Hopkins University School of Medicine , Baltimore, MD,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4965-3259","authenticated-orcid":false,"given":"Clare","family":"Pain","sequence":"additional","affiliation":[{"name":"Department of Paediatric Rheumatology, Alder Hey Children\u2019s NHS Foundation Trust , Liverpool,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3975-8938","authenticated-orcid":false,"given":"Christopher P","family":"Denton","sequence":"additional","affiliation":[{"name":"Centre for Rheumatology and Connective Tissue Diseases, Division of Medicine, University College London , London,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2793-2364","authenticated-orcid":false,"given":"John D","family":"Pauling","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, North Bristol NHS Trust , Bristol,","place":["UK"]},{"name":"Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, University of Bristol , Bristol,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,8,4]]},"reference":[{"key":"2026081922063860500_rkag094-B1","doi-asserted-by":"publisher","first-page":"2737","DOI":"10.1002\/ART.38098","article-title":"2013 classification criteria for systemic sclerosis: an American College of Rheumatology\/European League Against Rheumatism collaborative initiative","volume":"65","author":"van den Hoogen","year":"2013","journal-title":"Arthritis 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