Impact of social deprivation on cancer occurrence and cardiovascular events in systemic sclerosis

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Abstract
Objectives: 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. Methods: 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. Results: In 2024, ≈6000 people with SSc (84.6% female, 70.8% between 51 and 80 years of age, 73.3% White ethnicity) accessed secondary healthcare in England. Older SSc patients were overrepresented in less-deprived postcodes (P < 0.001). 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 < 0.001). The all-cause mortality attrition rate was ≈3% in SSc over 3 months (30.8% with lung cancer and >60% with melanoma). Rates of breast cancer were higher in SSc compared with SLE (P = 0.014) and RA (P = 0.012). There was a higher rate of lung cancer in SSc compared with SLE (P < 0.001). Melanoma rates were similar across diseases (≈0.2%). Conclusion: 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.
Funding Information
  • Wellcome Trust Early Career Award (316390/Z/24/Z)

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