Cancer patients, especially those newly diagnosed with blood cancers and treated with chemotherapy, have an elevated risk of developing shingles, according to a new study.

The large, prospective study published in the Journal of Infectious Diseases examined the risk of shingles before and after a new cancer diagnosis across a range of cancer types among approximately 240,000 adults in Australia from 2006 to 2015.

University of New South Wales–led researchers determined that a cancer diagnosis of any type was associated with about a 40% increase in risk of developing shingles versus someone without cancer.

In addition, patients with a hematological cancer diagnosis had a more than threefold higher risk of developing shingles compared with people without cancer. Individuals with a diagnosis of cancer related to a solid tumor, on the other hand, had a 30% higher shingles risk compared with  someone with no cancer.

Over more than 1.7 million person-years of follow-up, 20,286 new cancer diagnoses and 16,350 herpes zoster events occurred. Participants with hematological and solid cancer had higher relative risks of zoster than those without cancer (adjusted hazard ratio [aHR], 3.74 [95% CI, 3.11-4.51] and 1.30 [95% CI, 1.21-1.40], respectively), the study team reported.

“For hematological cancer, increases in zoster risk are apparent in the 2 years preceding diagnosis and treatment; for solid organ cancers, the increased risk appears to be largely associated with receipt of chemotherapy,” the authors wrote.

“These findings have important implications in view of recent advances in development of zoster vaccines,” wrote Kosuke Kawai, ScD, of Boston Children’s Hospital and Harvard Medical School, and Barbara P. Yawn, MD, MsC, of the University of Minnesota, in a related editorial commentary.

The commentators point out, “A new shingles vaccine approved for used in the U.S. in 2017 does not use a live form of the virus and is likely to be safe in people with compromised immune systems, such as those on chemotherapy.”

While public-health officials are still awaiting more data on the vaccines used in those patients, both the study and the commentary suggest that vaccination holds great promise as a strategy to prevent shingles and its complications in cancer patients.

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