Herpes zoster is not associated with subsequent gastrointestinal cancer: data from over 200,000 outpatients in Germany

J Cancer Res Clin Oncol. 2023 Dec;149(19):17115-17121. doi: 10.1007/s00432-023-05432-4. Epub 2023 Sep 27.

Abstract

Purpose: Gastrointestinal (GI) cancers are an increasing global health challenge. Viral diseases play an important role in the development of GI cancers. For example, Epstein-Barr virus, which belongs to the human herpesvirus family, is a well-recognized risk factor for the development of gastric cancer. The purpose of this study was to investigate a possible association between varicella-zoster virus reactivation and subsequent diagnosis of GI cancer.

Methods: In this retrospective cohort study, a total of 103,123 patients with a first diagnosis of herpes zoster (HZ) between 2005 and 2021 were propensity score matched to a cohort of 103,123 patients without HZ. Patient data was extracted from the Disease Analyzer database (IQVIA). The incidence of GI cancer was compared as a function of HZ. Cox regression analysis was used to examine the association between HZ and GI cancer.

Results: Over a follow-up period of up to 10 years, the incidence of GI cancer did not differ between the two cohorts (HZ cohort 2.26 cases per 1000 patient-years vs. non-HZ cohort 2.37 cases per 1000 patient-years, p = 0.548). In regression analysis, HZ was not associated with an increased risk of developing GI cancer (HR: 0.97; 95% CI 0.89-1.05). Furthermore, no significant effect of the presence of HZ on the incidence of different GI cancer entities was found.

Conclusion: In this retrospective cohort study consisting of well-matched patients, we observed no significant association between a HZ infection and the development of GI cancer during a long-term follow-up.

Keywords: Epidemiology; Gastrointestinal cancer; Herpes zoster; Malignancy; Varicella zoster virus.

MeSH terms

  • Epstein-Barr Virus Infections* / complications
  • Epstein-Barr Virus Infections* / epidemiology
  • Gastrointestinal Neoplasms* / epidemiology
  • Germany / epidemiology
  • Herpes Zoster* / complications
  • Herpes Zoster* / diagnosis
  • Herpes Zoster* / epidemiology
  • Herpesvirus 3, Human
  • Herpesvirus 4, Human
  • Humans
  • Incidence
  • Outpatients
  • Retrospective Studies