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.

Aimee Lettis from the GP Update team gives us short, sharp nuggets of clinical information for sessional GPs. The GP Update team run one-day courses, bringing GPs up to date with all the latest evidence and guidelines.

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