Increased risk of a cancer diagnosis after Herpes zoster ophthalmicus: A nationwide population-based study

Jau Der Ho, Sudha Xirasagar, Herng Ching Lin

Research output: Contribution to journalArticle

24 Citations (Scopus)

Abstract

Purpose Herpes zoster has been associated with immune suppression, as has an increased risk of cancer. This population-based follow-up study aimed to investigate the risk of a subsequent cancer diagnosis after herpes zoster ophthalmicus (HZO). Design A retrospective cohort study. Participants and Controls Retrospective claims data from the Taiwan National Health Insurance Research Database were analyzed. The study cohort comprised all patients with a diagnosis of HZO (International Classification of Diseases, 9th Revision, Clinical Modification code 053.2) in 2003 and 2004 (n=658). The comparison cohort consisted of randomly selected ambulatory care patients, 8 for every patient with HZO (n=5264) matched with the study group on age, gender, monthly income, and urbanization level of the patient's residence. Methods The Kaplan-Meier method was used to compute 1-year cancer-free survival rate. Stratified Cox proportional hazard regressions were carried out to compute the adjusted 1-year cancer-free survival rate after adjusting for potential confounding factors. Main Outcome Measures Subsequent claims for all study and comparison patients were captured over a 1-year follow-up period from their index ambulatory care visit to identify whether the patient received a cancer diagnosis during the follow-up period. Results During 1-year follow-up, cancer was diagnosed in 4.86% of patients with HZO and 0.53% of patients in the comparison cohort. Patients with HZO had significantly lower 1-year cancer-free survival rates than the comparison cohort. After adjusting for patient age, gender, monthly income, and urbanization level, patients with HZO were found to have a 9.25-fold (95% confidence interval, 5.51-15.55) risk of a subsequent cancer diagnosis than the matched comparison cohort. No significant differences in cancer type were observed between the 2 cohorts. Conclusions Herpes zoster ophthalmicus may be a marker of increased risk of being diagnosed with cancer in the following year. Financial Disclosure(s) The author(s) have no proprietary or commercial interest in any materials discussed in this article.

Original languageEnglish
Pages (from-to)1076-1081
Number of pages6
JournalOphthalmology
Volume118
Issue number6
DOIs
Publication statusPublished - Jun 2011

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Herpes Zoster Ophthalmicus
Population
Neoplasms
Urbanization
Survival Rate
Ambulatory Care
Cohort Studies
Disclosure
Herpes Zoster
National Health Programs
International Classification of Diseases
Taiwan

ASJC Scopus subject areas

  • Ophthalmology

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Increased risk of a cancer diagnosis after Herpes zoster ophthalmicus : A nationwide population-based study. / Ho, Jau Der; Xirasagar, Sudha; Lin, Herng Ching.

In: Ophthalmology, Vol. 118, No. 6, 06.2011, p. 1076-1081.

Research output: Contribution to journalArticle

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title = "Increased risk of a cancer diagnosis after Herpes zoster ophthalmicus: A nationwide population-based study",
abstract = "Purpose Herpes zoster has been associated with immune suppression, as has an increased risk of cancer. This population-based follow-up study aimed to investigate the risk of a subsequent cancer diagnosis after herpes zoster ophthalmicus (HZO). Design A retrospective cohort study. Participants and Controls Retrospective claims data from the Taiwan National Health Insurance Research Database were analyzed. The study cohort comprised all patients with a diagnosis of HZO (International Classification of Diseases, 9th Revision, Clinical Modification code 053.2) in 2003 and 2004 (n=658). The comparison cohort consisted of randomly selected ambulatory care patients, 8 for every patient with HZO (n=5264) matched with the study group on age, gender, monthly income, and urbanization level of the patient's residence. Methods The Kaplan-Meier method was used to compute 1-year cancer-free survival rate. Stratified Cox proportional hazard regressions were carried out to compute the adjusted 1-year cancer-free survival rate after adjusting for potential confounding factors. Main Outcome Measures Subsequent claims for all study and comparison patients were captured over a 1-year follow-up period from their index ambulatory care visit to identify whether the patient received a cancer diagnosis during the follow-up period. Results During 1-year follow-up, cancer was diagnosed in 4.86{\%} of patients with HZO and 0.53{\%} of patients in the comparison cohort. Patients with HZO had significantly lower 1-year cancer-free survival rates than the comparison cohort. After adjusting for patient age, gender, monthly income, and urbanization level, patients with HZO were found to have a 9.25-fold (95{\%} confidence interval, 5.51-15.55) risk of a subsequent cancer diagnosis than the matched comparison cohort. No significant differences in cancer type were observed between the 2 cohorts. Conclusions Herpes zoster ophthalmicus may be a marker of increased risk of being diagnosed with cancer in the following year. Financial Disclosure(s) The author(s) have no proprietary or commercial interest in any materials discussed in this article.",
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N2 - Purpose Herpes zoster has been associated with immune suppression, as has an increased risk of cancer. This population-based follow-up study aimed to investigate the risk of a subsequent cancer diagnosis after herpes zoster ophthalmicus (HZO). Design A retrospective cohort study. Participants and Controls Retrospective claims data from the Taiwan National Health Insurance Research Database were analyzed. The study cohort comprised all patients with a diagnosis of HZO (International Classification of Diseases, 9th Revision, Clinical Modification code 053.2) in 2003 and 2004 (n=658). The comparison cohort consisted of randomly selected ambulatory care patients, 8 for every patient with HZO (n=5264) matched with the study group on age, gender, monthly income, and urbanization level of the patient's residence. Methods The Kaplan-Meier method was used to compute 1-year cancer-free survival rate. Stratified Cox proportional hazard regressions were carried out to compute the adjusted 1-year cancer-free survival rate after adjusting for potential confounding factors. Main Outcome Measures Subsequent claims for all study and comparison patients were captured over a 1-year follow-up period from their index ambulatory care visit to identify whether the patient received a cancer diagnosis during the follow-up period. Results During 1-year follow-up, cancer was diagnosed in 4.86% of patients with HZO and 0.53% of patients in the comparison cohort. Patients with HZO had significantly lower 1-year cancer-free survival rates than the comparison cohort. After adjusting for patient age, gender, monthly income, and urbanization level, patients with HZO were found to have a 9.25-fold (95% confidence interval, 5.51-15.55) risk of a subsequent cancer diagnosis than the matched comparison cohort. No significant differences in cancer type were observed between the 2 cohorts. Conclusions Herpes zoster ophthalmicus may be a marker of increased risk of being diagnosed with cancer in the following year. Financial Disclosure(s) The author(s) have no proprietary or commercial interest in any materials discussed in this article.

AB - Purpose Herpes zoster has been associated with immune suppression, as has an increased risk of cancer. This population-based follow-up study aimed to investigate the risk of a subsequent cancer diagnosis after herpes zoster ophthalmicus (HZO). Design A retrospective cohort study. Participants and Controls Retrospective claims data from the Taiwan National Health Insurance Research Database were analyzed. The study cohort comprised all patients with a diagnosis of HZO (International Classification of Diseases, 9th Revision, Clinical Modification code 053.2) in 2003 and 2004 (n=658). The comparison cohort consisted of randomly selected ambulatory care patients, 8 for every patient with HZO (n=5264) matched with the study group on age, gender, monthly income, and urbanization level of the patient's residence. Methods The Kaplan-Meier method was used to compute 1-year cancer-free survival rate. Stratified Cox proportional hazard regressions were carried out to compute the adjusted 1-year cancer-free survival rate after adjusting for potential confounding factors. Main Outcome Measures Subsequent claims for all study and comparison patients were captured over a 1-year follow-up period from their index ambulatory care visit to identify whether the patient received a cancer diagnosis during the follow-up period. Results During 1-year follow-up, cancer was diagnosed in 4.86% of patients with HZO and 0.53% of patients in the comparison cohort. Patients with HZO had significantly lower 1-year cancer-free survival rates than the comparison cohort. After adjusting for patient age, gender, monthly income, and urbanization level, patients with HZO were found to have a 9.25-fold (95% confidence interval, 5.51-15.55) risk of a subsequent cancer diagnosis than the matched comparison cohort. No significant differences in cancer type were observed between the 2 cohorts. Conclusions Herpes zoster ophthalmicus may be a marker of increased risk of being diagnosed with cancer in the following year. Financial Disclosure(s) The author(s) have no proprietary or commercial interest in any materials discussed in this article.

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