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Herpes zoster as a marker of underlying malignancy
Today, Open Medicine <http://www.openmedicine.ca/> published a study assessing whether a diagnosis of herpes zoster is a risk factor for subsequent malignancy.
Both herpes zoster—more commonly known as shingles--and cancer are associated with suppression of the immune system; however, it has been unclear what, if any, association there is between an earlier finding of shingles and later diagnosis of a malignant tumor.
“This is, we believe, the largest study to date examining this association,” explains Dr. Karl Iglar, lead author on the paper published today, “Herpes zoster as a marker of underlying malignancy”. The research team looked back over records of adult patients with no previous diagnosis of cancer (or HIV) to identify 542 575 such patients with herpes zoster.
“The incidence of cancer was significantly greater among individuals with herpes zoster than among those without herpes zoster, for both men and women and across all time intervals studied (up to 5 years),” the authors wrote.
The study is one of the first to take a population-based approach to looking at a potential association between shingles and cancer. Unlike previous studies of the suspected association, the present study found a significant increase in cancer rates for both men and women and across the age span studied (18+). The authors found that incidence of cancer rises shortly after a herpes zoster episode—risk goes down as more time passes following the shingles attack—and that haematological cancers are the most strongly implicated.
“The general conclusion that can be reached,” says Dr. Iglar, “is that both physicians and patients should be attentive to the risk of cancers especially in the first six months following an episode of herpes zoster.”
For more information, please visit Open Medicine <http://www.openmedicine.ca/> and see the attached paper.
Karl Iglar, MD, CCFP, is a Family Physician with the Department of Family and Community Medicine at St. Michael’s Hospital and an Associate Professor in the Department of Family and Community Medicine at the University of Toronto, Toronto, Ontario. Alexander Kopp, BA, is a Senior Analyst with the Institute for Clinical Evaluative Sciences, Toronto, Ontario. Richard H. Glazier, MD, MPH, FCFP, is a Senior Scientist at the Institute for Clinical Evaluative Sciences; a Professor in the Department of Family and Community Medicine and the Dalla Lana School of Public Health, University of Toronto; a Scientist at the Centre for Research on Inner City Health in the Keenan Research Centre of the Li Ka Shing Knowledge Institute, St. Michael’s Hospital; and a Clinician Scientist and Family Physician in the Department of Family and Community Medicine, St. Michael’s Hospital, Toronto, Ontario.
For more information, please contact:
Communications and Public Affairs
St. Michael’s Hospital
416.864.6060 x 6537
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