New SCRIM Score Accurately Predicts Cancer Risk in Idiopathic Inflammatory Myopathy Patients: Study Shows
South Korea: A new clinical scoring system, known as the Scoring System for Cancer Risk in Idiopathic Inflammatory Myositis (SCRIM), has shown strong potential in accurately predicting and categorizing cancer risk among individuals diagnosed with idiopathic inflammatory myopathy (IIM).
The findings, published in Arthritis Research & Therapy, stem from a study led by Yun Kyu Kim and colleagues from the Division of Rheumatology, Seoul National University Hospital, Republic of Korea.
Patients with IIM are known to face a higher likelihood of developing cancer compared with the general population. However, the degree of risk varies widely depending on clinical features, myositis subtype, and autoantibody profiles. Recognizing the need for a structured and clinically usable tool, the researchers developed a model that could help clinicians identify which patients require closer surveillance.
The study evaluated 481 patients diagnosed with various forms of idiopathic inflammatory myopathy across four independent South Korean cohorts. The average age at diagnosis was 53.2 years, and nearly one-third of participants were men. Diagnoses were confirmed using established classification criteria.
Researchers assessed 24 clinical variables—including demographic attributes, IIM subtypes, key symptoms, response to initial treatment, and the presence of myositis-specific or myositis-associated autoantibodies—to identify factors linked with cancer development.
The key findings of the study were as follows:
- Myositis-associated cancer was defined as any malignancy occurring within three years before or after the diagnosis of idiopathic inflammatory myopathy (IIM).
- A total of 12.9% of patients in the cohort developed cancer, with lung cancer being the most frequently observed type.
- LASSO-based logistic regression identified older age, male sex, current smoking, dermatomyositis, and anti-TIF1-gamma positivity as high-risk predictors for cancer.
- Antisynthetase syndrome, overlap myositis, inflammatory arthritis, and interstitial lung disease were associated with a lower likelihood of developing cancer.
- These nine clinical and serological factors were used to create the SCRIM score, which showed strong predictive accuracy with an AUROC of 0.852.
- Patients were classified into three risk groups based on their total scores: low risk (≤2 points), intermediate risk (3–7 points), and high risk (≥8 points).
- Individuals in the low-risk category had cancer rates comparable to the general population, whereas those in the intermediate- and high-risk groups showed significantly higher cancer incidences.
Highlighting the practical value of this scoring system, the authors noted that about 40% of the study population fell into the low-risk category—suggesting that unnecessary extensive cancer screening could be avoided in a significant proportion of patients. “This approach significantly improved the accuracy of predicting myositis-associated malignancy and could enable more precise recommendations for cancer screening,” the authors wrote.
The researchers acknowledged certain limitations, including the need for external validation and variations in cancer screening practices across the study population. Additionally, some autoantibodies were underrepresented, which prevented a precise evaluation of their cancer associations.
“Despite these limitations, the SCRIM score emerges as a promising tool for guiding evidence-based cancer surveillance strategies in patients with idiopathic inflammatory myopathy. Further studies in diverse populations are expected to strengthen its clinical utility," the authors concluded.
Reference:
Kim, Y.K., Pyo, J.Y., Kim, J.Y. et al. The SCRIM score: a clinical tool for cancer risk-stratification in patients with idiopathic inflammatory myopathy. Arthritis Res Ther 27, 204 (2025). https://doi.org/10.1186/s13075-025-03666-w
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