Cancer Screening in Patients with Polymyalgia Rheumatica: Association as a Paraneoplastic Syndrome. A Systematic Literature Review

Tamizaje de cáncer en pacientes con polimialgia reumática : asociación como síndrome paranopleásico. Una revisión sistemática de la literatura

Introduction: Polymyalgia rheumatica is the most prevalent inflammatory disease in adults over 50 years, with an estimated incidence in Northern Europe ranging from 41 to 113 cases and a prevalence of 6 cases per 100,000 individuals over 50. Globally, cancer incidence is approximately 1,000 cases per 100,000 adults over 50, and the annual Asian prevalence (2020) was reported as 4,791,968 cases. The literature presents numerous studies exploring the association between polymyalgia rheumatica and paraneoplastic syndrome. This study aims to evaluate the potential association of polymyalgia rheumatica as a paraneoplastic syndrome.

Materials and Methods: A systematic literature review was conducted, focusing on observational studies that explored associations rather than interventions. The search spanned PubMed, Lilacs, and Scopus databases, limited to English and Spanish publications within the last 20 years. Case series and case reports were excluded. The search strategy employed was ((“polymyalgia rheumatica”) AND (“cancer OR neoplasm”)). Study quality was assessed using the JAMA guidelines for observational studies and the GRADE system for overall evidence evaluation. Risk of bias in observational studies was evaluated using the ROBINS-I tool. The review process involved three independent researchers, with a sequential filtering of titles, abstracts, and full text to assess scientific evidence. The primary outcome was the development of cancer following a diagnosis of polymyalgia rheumatica, quantified by measures of disease occurrence or risk.