Hoa S, Lazizi S, Baron M, et al. - In this large cohort of predominantly female and White systemic sclerosis (SSc) patients, synchronous cancer was uncommon. Patients who tested positive for anti-topoisomerase I or anti-U1-RNP had a higher risk of developing cancer within 2 years. Autoantibody-guided screening strategies necessitate additional thought.

• Of the 1,698 SSc patients studied, 1,481 (87%) had available autoantibody data.

• Cancer was diagnosed in 1.3%, 2.1% and 3.5% of patients within 2, 3, and 5 years of the first non-Raynaud manifestation, respectively.

• Breast, gynecological and hematological cancers were the most frequent cancers diagnosed within 2 years.

• Anti-topoisomerase I and anti-U1-RNP-positive patients had a higher risk of cancer within 2 years, but not anti-RNA polymerase III-positive patients.

• Within 2 years, none of the anti-fibrillarin, Th/To, PM/Scl, Ku, or NOR90-positive patients developed cancer.

• Patients who had anti-centromere autoantibodies or none of the other autoantibodies tested had a numerically lower risk of developing cancer within 2 years.