{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T23:35:05Z","timestamp":1793316905653,"version":"4.5.0"},"reference-count":52,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2025,10,28]],"date-time":"2025-10-28T00:00:00Z","timestamp":1761609600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Idiopathic inflammatory myopathies (IIMs) are rare autoimmune diseases with extra-muscular manifestations. A firm association with malignancy, mainly observed in dermatomyositis (DM) is well established and several predictors of malignancy were previously published. However, given the low prevalence of IIMs, large population-based studies are scarce, hindering a comprehensive understanding of site-specific cancer patterns and risk factors. This study aimed to evaluate malignancy patterns and predictors, in a large, diverse cohort of patients with DM and PM. Materials and Methods: This retrospective cohort study used the Clalit Health Services electronic database, including 1557 DM patients and 528 PM patients diagnosed between 2002 and 2018, along with age-, sex-, and residence-matched controls at a 1:5 ratio. The incidence and risk of malignancies were assessed using Cox proportional hazards models, and predictors of solid and hematologic malignancies within the PM\/DM cohort were analyzed using adjusted logistic regression. Results: In our cohort, DM was associated with an increased risk of both solid and hematologic malignancies (HR 1.89, 95%CI 1.47\u20132.41), whereas in PM the association was less pronounced and limited to solid malignancies (HR 1.50, 95%CI 1.06\u20132.11). In DM, higher risks were observed for breast cancer (HR 1.86) and chronic leukemia (HR 5.02). Across both subtypes, older age at diagnosis, the presence of specific autoantibodies were associated with increased malignancy risk. Significant markers included antiphospholipid antibodies (OR 2.28), lupus anticoagulant (OR 2.29), anti-Mi2 (OR 2.09), any of the antinuclear antibodies (OR 2.37), and individually anti-RNP\/Sm (OR 1.70), anti-Ro\/La (OR 1.79), anti-Scl-70 (OR 1.60), and anti-DNA (OR 1.97). Conclusions: Our study demonstrates an increased risk of malignancy in both DM and PM, with the relationship being stronger and broader in DM, involving both solid and hematologic cancers. Older age at diagnosis, and a distinct serological profile, particularly antiphospholipid antibodies and various antinuclear antibodies, identify patients at highest risk, warranting heightened clinical vigilance.<\/jats:p>","DOI":"10.3390\/medicina61111932","type":"journal-article","created":{"date-parts":[[2025,10,28]],"date-time":"2025-10-28T11:47:19Z","timestamp":1761652039000},"page":"1932","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Malignancy Risk and Predictors in Dermatomyositis and Polymyositis: A Large Population-Based Study"],"prefix":"10.3390","volume":"61","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0412-1729","authenticated-orcid":false,"given":"Yonatan Shneor","family":"Patt","sequence":"first","affiliation":[{"name":"Department of Internal Medicine B & Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer, Ramat Gan 5262100, Israel"},{"name":"Gray Faculty of Medical and Health Sciences, Tel-Aviv University, Tel-Aviv 6927846, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4721-2003","authenticated-orcid":false,"given":"Niv","family":"Ben-Shabat","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine B & Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer, Ramat Gan 5262100, Israel"},{"name":"Dina Recanati School of Medicine, Reichman University, Herzliya 4610101, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paula","family":"David","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine B & Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer, Ramat Gan 5262100, Israel"},{"name":"Gray Faculty of Medical and Health Sciences, Tel-Aviv University, Tel-Aviv 6927846, Israel"},{"name":"Section of Musculoskeletal Disease, NIHR Leeds Musculoskeletal Biomedical Research Unit, Chapel Allerton, Leeds Teaching Hospital Trust, Leeds LS1 3EX, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chen","family":"Patt","sequence":"additional","affiliation":[{"name":"Gray Faculty of Medical and Health Sciences, Tel-Aviv University, Tel-Aviv 6927846, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3905-3313","authenticated-orcid":false,"given":"Kassem","family":"Sharif","sequence":"additional","affiliation":[{"name":"Gray Faculty of Medical and Health Sciences, Tel-Aviv University, Tel-Aviv 6927846, Israel"},{"name":"Center for Advanced Endoscopy, Harvard Medical School, Boston, MA 02108, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-5285-6695","authenticated-orcid":false,"given":"Yoav","family":"Elizur","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine B & Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer, Ramat Gan 5262100, Israel"},{"name":"Gray Faculty of Medical and Health Sciences, Tel-Aviv University, Tel-Aviv 6927846, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ido","family":"Cohen","sequence":"additional","affiliation":[{"name":"Gray Faculty of Medical and Health Sciences, Tel-Aviv University, Tel-Aviv 6927846, Israel"},{"name":"Department of Internal Medicine E, Sheba Medical Center, Tel-Hashomer, Ramat Gan 5262100, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arnon D.","family":"Cohen","sequence":"additional","affiliation":[{"name":"Chief Physician\u2019s Office, Clalit Health Services, Tel-Aviv 6209813, Israel"},{"name":"Siaal Research Center for Family Medicine and Primary Care, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva 8410501, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5406-7716","authenticated-orcid":false,"given":"Howard","family":"Amital","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine B & Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer, Ramat Gan 5262100, Israel"},{"name":"Gray Faculty of Medical and Health Sciences, Tel-Aviv University, Tel-Aviv 6927846, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1404-8027","authenticated-orcid":false,"given":"Abdulla","family":"Watad","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine B & Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer, Ramat Gan 5262100, Israel"},{"name":"Gray Faculty of Medical and Health Sciences, Tel-Aviv University, Tel-Aviv 6927846, Israel"},{"name":"Section of Musculoskeletal Disease, NIHR Leeds Musculoskeletal Biomedical Research Unit, Chapel Allerton, Leeds Teaching Hospital Trust, Leeds LS1 3EX, UK"},{"name":"Rheumatology Unit, Sheba Medical Centre, Tel-Hashomer, Ramat Gan 5262100, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Omer","family":"Gendelman","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine B & Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer, Ramat Gan 5262100, Israel"},{"name":"Gray Faculty of Medical and Health Sciences, Tel-Aviv University, Tel-Aviv 6927846, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,10,28]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"971","DOI":"10.1016\/S0140-6736(03)14368-1","article-title":"Polymyositis and 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