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

Abstract Objectives Cardiovascular events (CVE) and malignancy are important non-disease-related causes of mortality in systemic sclerosis (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 (IMD) deciles. Myocardial infarction (MI), lung cancer, breast cancer, melanoma rates and short-term all-cause mortality was explored, alongside comparisons with Systemic Lupus Erythematosus (SLE) and Rheumatoid Arthritis (RA). Results In 2024, ∼6,000 people with SSc (84.6% female, 70.8% aged between 51-80 years; 73.3% White ethnicity) accessed secondary healthcare in England. Older SSc patients were over-represented in less deprived postcodes (P < 0.001). MI, lung cancer, breast cancer and melanoma were more common in SSc compared with un-matched estimates in general population. Lung cancer was more frequent amongst less deprived patients (P < 0.001). The all-cause mortality attrition rate was ∼3% in SSc over three months (30.8% with lung cancer and >60% with melanoma). Rates of breast cancer were higher in SSc compared to SLE (P = 0.014) and RA (P = 0.012). There was a higher rate of lung cancer in SSc compared to 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 to SLE and RA. Our findings might support healthcare services planning and cancer screening for SSc in England.