GP Update | Risk of cancer diagnosis after herpes zoster

We know that shingles occurs more commonly in cancer patients. It has been postulated that the risk of a cancer diagnosis after zoster may also be increased. This large UK-based primary care study has shed some light on this (BJC 2013;108:721). They compared cancer risk in patients with a diagnosis of shingles to matched controls and found:

  • Patients with a diagnosis of zoster were more than twice as likely to develop cancer in the following years than matched controls (HR 2.42, CI 2.21-2.66).
  • Median time to cancer diagnosis was 815 days.
  • Hazard ratios were more significant for younger patients, e.g. aged 18-50y (HR 6.57, CI 4.18-10.41).

The authors do not advocate routinely investigating all patients with zoster. Instead, they suggest considering it as an additional risk factor which should perhaps lower our threshold for further investigation.

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