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DM Cancer Risk — SCE Dermatology MCQ

Instant feedback + full explanation. One question, done properly.

HardConnective Tissue & VasculitisDM Cancer RiskSCE Dermatology

A 58-year-old woman has newly diagnosed dermatomyositis with dysphagia and anti-TIF1-gamma antibodies. She has no interstitial lung disease. How should her malignancy risk be classified for screening intensity?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: E — High-risk phenotype with screening beyond the basic age-related programme

Explanation lettering: E = shown as B · D = shown as C · C = shown as D · B = shown as E

B is correct. IMACS risk stratification identifies dermatomyositis, anti-TIF1-gamma positivity, older age at onset and moderate-to-severe dysphagia as malignancy-risk features. Their combination warrants enhanced screening rather than routine age-based screening alone. Anti-synthetase features and interstitial lung disease tend to sit in lower-risk strata, but their absence does not negate the positive high-risk features.

Reference: IMACS international guideline: cancer screening in idiopathic inflammatory myopathy: https://www.nature.com/articles/s41584-023-01045-w