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Is herpes zoster a marker for occult or subsequent malignancy?
Frank Buntinx1, Richard Wachana, Stefaan Bartholomeeusen
1Department of General Practice, University of Leuven, Leuven, Belgium. Frank.buntinx@med.kuleuven.ac.be
Summary
Herpes zoster (shingles) may indicate cancer in older adults, particularly women over 65. However, the study does not support routine cancer screening after shingles diagnosis.
Area of Science:
- Epidemiology
- Oncology
- Infectious Diseases
Background:
- Herpes zoster (shingles) has been hypothesized as a potential indicator of underlying occult malignancy.
- Understanding this association is crucial for clinical practice and patient management.
Purpose of the Study:
- To investigate the incidence of subsequent cancer diagnoses in individuals with and without a history of herpes zoster.
- To determine if herpes zoster serves as a predictive marker for malignancy.
Main Methods:
- A retrospective cohort study design was employed.
- Data were sourced from the Intego database, a Belgian general practice registry (1994-2000).
- Survival analysis was used to compare cancer emergence rates between patients with and without herpes zoster.
Main Results:
- The study found a significant increase in cancer emergence among patients over 65 years old diagnosed with herpes zoster, especially in females (HR=2.65).
- No significant association was observed in patients under 65 or within the first year post-herpes zoster infection.
- The association was not significant in males over 65.
Conclusions:
- The findings do not warrant widespread cancer screening for all herpes zoster patients.
- The identified association between herpes zoster and cancer suggests potential underlying pathophysiological links requiring further investigation.