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Increased risk of cancer after Bell’s palsy: a 5-year follow-up study

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Abstract

Reactivation of latent herpes simplex virus (HSV) type I or varicella-zoster virus (VZV) has been recognized as the most common pathomechanism underlying Bell’s palsy. There is also increased reactivation of HSV or VZV in patients with immunosuppressed states and in cancer patients. The purpose of this study was to investigate the risk for cancer during a 5-year follow-up period after diagnosis of Bell’s palsy by using a population-based dataset in Taiwan. We used data from the “Longitudinal Health Insurance Database”. We identified 2,618 patients with Bell’s palsy as the study cohort and randomly selected 13,090 patients to be used as a comparison cohort. Cox proportional hazards regression was performed to compare the 5-year risk of subsequent cancer between the study and comparison cohorts. We found that the incidence of cancer was 1.55 (95 % CI 1.35–1.78) per 100 person-years for patients with Bell’s palsy and 1.09 (95 % CI 1.02–1.18) per 100 person-years for comparison patients. After censoring cases that died from non-cancer causes during the follow-up period and adjusting for urbanization, monthly income, geographic region, and diabetes, the hazard ratio (HR) for cancer during the 5-year follow-up period for patients with Bell’s palsy was 1.43 times that for comparison patients (95 % CI 1.22–1.73). There was a particularly increased risk of oral cancer (HR = 2.49; 95 % CI 1.54–4.03) for patients with Bell’s palsy compared with the other patients. We conclude that patients with Bell’s palsy were at significant risk of cancer during a 5-year follow-up period after diagnosis.

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Acknowledgments

This study is based in part on data from the National Health Insurance Research Database provided by the Bureau of National Health Insurance, Department of Health, Taiwan, and managed by the National Health Research Institutes. The interpretations and conclusions contained herein do not represent those of the Bureau of National Health Insurance, Department of Health, or the National Health Research Institutes.

Conflict of interest

All authors have no conflicts of interest to declare.

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Authors and Affiliations

  1. Department of Neurology, Taipei Medical University Hospital, Taipei, Taiwan

    Jau-Jiuan Sheu

  2. Neuroscience Research Center, Taipei Medical University Hospital, Taipei, Taiwan

    Jau-Jiuan Sheu

  3. Department of Neurology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan

    Jau-Jiuan Sheu

  4. School of Public Health, Taipei Medical University, Taipei, Taiwan

    Joseph J. Keller

  5. School of Health Care Administration, College of Medicine, Taipei Medical University, 250 Wu-Hsing St., Taipei, 110, Taiwan

    Herng-Ching Lin

Authors
  1. Jau-Jiuan Sheu
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  2. Joseph J. Keller
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  3. Herng-Ching Lin
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Correspondence to Herng-Ching Lin.

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Sheu, JJ., Keller, J.J. & Lin, HC. Increased risk of cancer after Bell’s palsy: a 5-year follow-up study. J Neurooncol 110, 215–220 (2012). https://doi.org/10.1007/s11060-012-0954-9

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  • DOI: https://doi.org/10.1007/s11060-012-0954-9

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