The Association between Infectious Mononucleosis and Cancer: A Cohort Study of 24,190 Outpatients in Germany
Background: Cancer represents one of the leading causes of death worldwide. Besides genetic risk factors and non-communicable diseases, chronic infections including Epstein–Barr virus (EBV) infection have been identified as promotors of cancer. In the present manuscript, we evaluated the association...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-11-01
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| Series: | Cancers |
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| Online Access: | https://www.mdpi.com/2072-6694/14/23/5837 |
| _version_ | 1797463477466431488 |
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| author | Christoph Roderburg Sarah Krieg Andreas Krieg Tom Luedde Karel Kostev Sven H. Loosen |
| author_facet | Christoph Roderburg Sarah Krieg Andreas Krieg Tom Luedde Karel Kostev Sven H. Loosen |
| author_sort | Christoph Roderburg |
| collection | DOAJ |
| description | Background: Cancer represents one of the leading causes of death worldwide. Besides genetic risk factors and non-communicable diseases, chronic infections including Epstein–Barr virus (EBV) infection have been identified as promotors of cancer. In the present manuscript, we evaluated the association between infectious mononucleosis, the clinical manifestation of EBV infection, and cancer development in a real-word cohort of outpatients in Germany. Methods: We used the Disease Analyzer database (IQVIA) and matched a total of 12,095 patients with infectious mononucleosis to a cohort of individuals without infectious mononucleosis based on age, sex, index year, and annual patient consultation frequency between 2000 and 2018. Results: Patients diagnosed with infectious mononucleosis had a cancer incidence of 5.3 cases per 1000 person years versus 4.4 cases per 1000 person years for patients without infectious mononucleosis. In multivariable regression models, infectious mononucleosis showed a trend towards a higher incidence of cancer in general in the age group > 50 years (incidence rate ratio (IRR): 1.32; 95% CI: 1.04–1.67) and among men (IRR: 1.36; 95% CI: 1.07–1.72). Infectious mononucleosis was significantly associated with an increased incidence of tumors of the hematopoietic and lymphoid tissues (IRR: 1.75; 95% CI: 1.22–2.50) and showed a strong trend towards an association with prostate cancer (IRR: 3.09; 95% CI: 1.23–7.76). Conclusion: Infectious mononucleosis is associated with an increased incidence of certain cancer types. The present data from a large real-world cohort support the evidence on a role of EBV in the development of different malignancies and could trigger research efforts to further elucidate its precise involvement in the carcinogenic process. |
| first_indexed | 2024-03-09T17:52:11Z |
| format | Article |
| id | doaj.art-4a5bce0088764e6287cbdda13e7e084c |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-09T17:52:11Z |
| publishDate | 2022-11-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-4a5bce0088764e6287cbdda13e7e084c2023-11-24T10:39:29ZengMDPI AGCancers2072-66942022-11-011423583710.3390/cancers14235837The Association between Infectious Mononucleosis and Cancer: A Cohort Study of 24,190 Outpatients in GermanyChristoph Roderburg0Sarah Krieg1Andreas Krieg2Tom Luedde3Karel Kostev4Sven H. Loosen5Department for Gastroenterology, Hepatology and Infectious Diseases, University Hospital Duesseldorf, Medical Faculty of Heinrich Heine University Duesseldorf, 40225 Duesseldorf, GermanyDepartment for Gastroenterology, Hepatology and Infectious Diseases, University Hospital Duesseldorf, Medical Faculty of Heinrich Heine University Duesseldorf, 40225 Duesseldorf, GermanyDepartment of Surgery (A), University Hospital Duesseldorf, Medical Faculty of Heinrich Heine University Duesseldorf, 40225 Duesseldorf, GermanyDepartment for Gastroenterology, Hepatology and Infectious Diseases, University Hospital Duesseldorf, Medical Faculty of Heinrich Heine University Duesseldorf, 40225 Duesseldorf, GermanyEpidemiology, IQVIA, 60549 Frankfurt, GermanyDepartment for Gastroenterology, Hepatology and Infectious Diseases, University Hospital Duesseldorf, Medical Faculty of Heinrich Heine University Duesseldorf, 40225 Duesseldorf, GermanyBackground: Cancer represents one of the leading causes of death worldwide. Besides genetic risk factors and non-communicable diseases, chronic infections including Epstein–Barr virus (EBV) infection have been identified as promotors of cancer. In the present manuscript, we evaluated the association between infectious mononucleosis, the clinical manifestation of EBV infection, and cancer development in a real-word cohort of outpatients in Germany. Methods: We used the Disease Analyzer database (IQVIA) and matched a total of 12,095 patients with infectious mononucleosis to a cohort of individuals without infectious mononucleosis based on age, sex, index year, and annual patient consultation frequency between 2000 and 2018. Results: Patients diagnosed with infectious mononucleosis had a cancer incidence of 5.3 cases per 1000 person years versus 4.4 cases per 1000 person years for patients without infectious mononucleosis. In multivariable regression models, infectious mononucleosis showed a trend towards a higher incidence of cancer in general in the age group > 50 years (incidence rate ratio (IRR): 1.32; 95% CI: 1.04–1.67) and among men (IRR: 1.36; 95% CI: 1.07–1.72). Infectious mononucleosis was significantly associated with an increased incidence of tumors of the hematopoietic and lymphoid tissues (IRR: 1.75; 95% CI: 1.22–2.50) and showed a strong trend towards an association with prostate cancer (IRR: 3.09; 95% CI: 1.23–7.76). Conclusion: Infectious mononucleosis is associated with an increased incidence of certain cancer types. The present data from a large real-world cohort support the evidence on a role of EBV in the development of different malignancies and could trigger research efforts to further elucidate its precise involvement in the carcinogenic process.https://www.mdpi.com/2072-6694/14/23/5837EBVEpstein–Barr-Virusinfectious mononucleosislymphomacancerhematopoietic tissue |
| spellingShingle | Christoph Roderburg Sarah Krieg Andreas Krieg Tom Luedde Karel Kostev Sven H. Loosen The Association between Infectious Mononucleosis and Cancer: A Cohort Study of 24,190 Outpatients in Germany Cancers EBV Epstein–Barr-Virus infectious mononucleosis lymphoma cancer hematopoietic tissue |
| title | The Association between Infectious Mononucleosis and Cancer: A Cohort Study of 24,190 Outpatients in Germany |
| title_full | The Association between Infectious Mononucleosis and Cancer: A Cohort Study of 24,190 Outpatients in Germany |
| title_fullStr | The Association between Infectious Mononucleosis and Cancer: A Cohort Study of 24,190 Outpatients in Germany |
| title_full_unstemmed | The Association between Infectious Mononucleosis and Cancer: A Cohort Study of 24,190 Outpatients in Germany |
| title_short | The Association between Infectious Mononucleosis and Cancer: A Cohort Study of 24,190 Outpatients in Germany |
| title_sort | association between infectious mononucleosis and cancer a cohort study of 24 190 outpatients in germany |
| topic | EBV Epstein–Barr-Virus infectious mononucleosis lymphoma cancer hematopoietic tissue |
| url | https://www.mdpi.com/2072-6694/14/23/5837 |
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