Herpes zoster (HZ) is associated with a modestly increased risk of several cancers, particularly hematologic malignancies, according to a study published online first in the journal Cancer Epidemiology, Biomarkers & Prevention. The researchers found the strongest associations occurred when HZ diagnosis was 1 to 3 years before cancer diagnosis.

HZ is due to age-related decline in immunity in older persons. The researchers conducted a case-control study to assess whether HZ, as an indicator of suppressed immunity, is associated with increased risk of cancer.

Using the Surveillance, Epidemiology, and End Results (SEER)-Medicare linked database, the researchers reviewed 1 108 986 cases of people 65 years and older with first cancers identified in cancer registries from 1992 to 2005. They also included 100 000 cancer-free persons frequency matched to cases on age, sex, and year of selected. HZ diagnoses were identified via Medicare claims.

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The researchers constructed regression models to determine adjusted associations between cancer and HZ. Their findings show HZ prevalence was modestly higher in case patients than in control patients.

Significant associations were seen between HZ and oral cavity/pharyngeal, colon, lung, and nonmelanoma skin cancers; myeloma; diffuse large B cell lymphoma; lymphoplasmacytic lymphoma; and chronic lymphocytic leukemia/small lymphocytic lymphoma. Associations between HZ and solid cancers were mostly with regional and/or distant stage tumors.

Associations with cancer were strongest when HZ was diagnosed 13 to 35 months before a cancer diagnosis. For some cancers, associations were significant 36 to 59 months after HZ diagnosis, and 60+ months for lymphoplasmacytic lymphoma.

The researchers conclude that age-related decline in immunity does not play a major role in risk for cancer in older persons, but may be a concerning factor for some lymphomas.


1. Mahale P, Yanik EL, Engels EA. Herpes zoster and risk of cancer in the elderly US population [published online ahead of print]. Cancer Epidemiol Biomarkers Prev. doi:10.1158/1055-9965.EPI-15-1033.