Dutton Katherine, Soden Muriel
Department of Rheumatology, Royal Brisbane & Women's Hospital, Brisbane, Queensland, Australia.
Department of Rheumatology, Townsville Hospital, Townsville, Queensland, Australia.
Intern Med J. 2017 Dec;47(12):1367-1375. doi: 10.1111/imj.13556.
The international literature advocates for cancer screening in newly diagnosed patients with autoimmune myositis; however, there is no widely accepted consensus or guideline to outline the optimal cancer screening strategy and the evidence is currently insufficient to support any recommendation.
Our study aimed to establish the current trends in practice in malignancy screening in autoimmune myositis among Australian rheumatologists.
All rheumatologists who were full members of the Australian Rheumatology Association in 2016 (386) were invited to complete an online questionnaire. Respondent demographics and information on screening approach and concerns were collected using multiple choice and open-response questions. There were 60 respondents (16% response rate). All available quantitative data were analysed and reported using statistical software. Qualitative data were analysed and grouped according to themes.
Most respondents (93%) performed cancer screening. Significant variation was found in terms of approach to patient selection, choice of screening test, delegation of screening and repeat screening. A lack of clinical practice consensus and guideline (77%), test selection knowledge (37%), knowledge on repeated screening (53%) and the potential for harm (62%) were identified challenges in this area.
Malignancy screening in autoimmune myositis was variable among this small cohort of Australian rheumatologists. The observed differences were driven by patient factors and clinician preferences. The group identified several challenges in the cancer screening process. Further research is warranted to address these challenges, close the evidence gap and develop workable guidelines.
国际文献提倡对新诊断的自身免疫性肌炎患者进行癌症筛查；然而，目前尚无广泛接受的共识或指南来概述最佳的癌症筛查策略，且现有证据不足以支持任何推荐。
我们的研究旨在确定澳大利亚风湿病学家对自身免疫性肌炎进行恶性肿瘤筛查的当前实践趋势。
邀请所有在2016年成为澳大利亚风湿病协会正式会员的风湿病学家（共386人）完成一份在线问卷。通过多项选择题和开放式问题收集受访者的人口统计学信息以及有关筛查方法和担忧的信息。共有60名受访者（回复率为16%）。所有可得的定量数据均使用统计软件进行分析和报告。定性数据则根据主题进行分析和分组。
大多数受访者（93%）进行了癌症筛查。在患者选择方法、筛查测试选择、筛查委托和重复筛查方面发现了显著差异。在这一领域，缺乏临床实践共识和指南（77%）、测试选择知识（37%）、重复筛查知识（53%）以及潜在危害（62%）被确定为挑战。
在这一小群澳大利亚风湿病学家中，对自身免疫性肌炎进行恶性肿瘤筛查的情况存在差异。观察到的差异是由患者因素和临床医生偏好驱动的。该小组确定了癌症筛查过程中的几个挑战。有必要进行进一步研究以应对这些挑战，缩小证据差距并制定可行的指南。
