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Polymyalgia Rheumatica and its Association with Cancer
Emily C Pfeifer1, Cynthia S Crowson2, Brittny T Major3
1Department of Internal Medicine, Mayo Clinic, Rochester, MN, United States.
Objective:
Polymyalgia rheumatica (PMR) is a common rheumatologic disease in the elderly population. Studies on the relationship between PMR and cancer have yielded mixed results and have been limited by multiple factors. This study examined the association between PMR and development of cancer in a community cohort.
Methods:
A population-based cohort of 359 patients with PMR diagnosed between 1/1/1970 and 12/31/1999 and followed to 12/31/2013 was assembled along with a comparison cohort of 357 subjects. Records of the PMR and comparator subjects were reviewed for details concerning diagnosis of cancer. The cumulative incidence of malignancy in patients with and without PMR, adjusted for the competing risk of death, was estimated and compared using methods of Gray. Cox proportional hazards models were used to assess the trends in malignancy over time.
Results:
There was no significant difference in the prevalence of malignancy prior to PMR incidence date/index date between the two groups with prior malignancies in 41 (11%) of patients with PMR, and 50 (14%) of non-PMR subjects (p-value=0.31). As well, there was no difference in the cumulative incidence of malignancy at 10 years following PMR incidence between patients with PMR and non-PMR subjects (cumulative incidence at 10 years ± SE: PMR 13.8 ± 2.0, control 13.1 ± 2.0; p-value=0.89).
Conclusion:
There is no increased risk of malignancy in patients who are diagnosed with PMR when compared to subjects without PMR in this population-based cohort.
Insights
Polymyalgia rheumatica (PMR) does not increase cancer risk. This study found no significant difference in malignancy rates between patients with PMR and the general population, offering reassurance for those diagnosed with this condition.
Area of Science:
- Rheumatology
- Oncology
- Epidemiology
Background:
- Polymyalgia rheumatica (PMR) is a common inflammatory condition affecting the elderly.
- Previous studies on the link between PMR and cancer have produced conflicting results.
- This research investigates the association between PMR and subsequent cancer development.
Purpose of the Study:
- To determine if patients diagnosed with polymyalgia rheumatica have an increased risk of developing cancer.
- To analyze cancer incidence in a community cohort with and without PMR.
Main Methods:
- A population-based cohort study comparing 359 PMR patients with 357 controls.
- Cancer diagnoses were reviewed for both groups.
- Cumulative incidence of malignancy was estimated and compared using statistical models, adjusting for competing risks.
Main Results:
- No significant difference in prior malignancy prevalence between PMR patients (11%) and controls (14%).
- Cumulative incidence of malignancy at 10 years was similar: 13.8% in PMR patients vs. 13.1% in controls.
- No statistically significant difference in cancer development was observed between the groups.
Conclusions:
- This population-based study indicates no elevated risk of malignancy in individuals diagnosed with polymyalgia rheumatica.
- The findings suggest that PMR itself is not associated with an increased likelihood of developing cancer.
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