Incidence rates of brain cancer following an outbreak of chronic fatigue syndrome

Abstract

Previous studies utilizing data from the Nevada Cancer Registry suggested a transient increase in non-Hodgkin’s lymphoma (NHL) and brain cancer in northern Nevada following an outbreak of Chronic Fatigue Syndrome (CFS) in that area which was not seen in southern Nevada which had no reported CFS outbreaks. A subsequent study from the National Cancer Institute (NCI) using data from the NCI’s Surveillance, Epidemiology and End Results(SEER) Program and Medicare documented the association between CFS and NHL on a national basis but no other cancer association was seen. Since brain cancer has a younger age distribution than NHL, we returned to the Nevada Cancer Registry and used ten more years of data and additional analyses to determine if there was an association between CFS and brain cancer by age. This study confirmed the increased incidence of brain cancer following the outbreak in northern Nevada but not southern Nevada with the increase limited to the under 65 age group, thus explaining why the SEER-Medicare analysis only analyzing data in the 65 and above age group did not detect this association.

Keywords

Chronic fatigue syndrome / Brain cancer / Incidence / Nevada

References

[1] Holmes GP, Kaplan JE, Gantz NM, et al. Chronic fatigue syndrome: a working case definition. Ann Intern Med. 1988; 108(3): 387-9. https://doi.org/10.7326/0003-4819-108-3-387

[2] Fukuda K, Straus SE, Hickie I, et al. The chronic fatigue syndrome: a comprehensive approach to its definition and study. International Chronic Fatigue Syndrome Study Group. Ann Intern Med. 1994; 121(12): 953-9. https://doi.org/10.7326/0003-4819-121-12-199412150-00009

[3] Briggs NC, Levine PH. A comparative review of systemic and neurological symptomatology in 12 outbreaks collectively described as chronic fatigue syndrome, epidemic neuromyasthenia, and myalgic encephalomyelitis. Clin Infect Dis. 1994; 18(Suppl 1): S32-42. PMid:8148451. https://doi.org/10.1093/clinids/18.Supplement_1.S32

[4] Henderson DA, Shelokov A. Epidemic neuromyasthenia; clinical syndrome. N Engl J Med. 1959; 260(16): 814-8.

[5] Barnes DM. Mystery disease at Lake Tahoe challenges virologists and clinicians. Science. 1986; 234(4776): 541-2. https://doi.org/10.1126/science.3020689

[6] Holmes GP, Kaplan JE, Stewart JA, et al. A cluster of patients with a chronic mononucleosis-like syndrome. Is Epstein-Barr virus the cause? JAMA. 1987; 257(17): 2297-302.

[7] Levine PH, Jacobson S, Pocinki AG, et al. Clinical, epidemiologic, and virologic studies in four clusters of the chronic fatigue syndrome. Arch Intern Med. 1992; 152(8): 1611-6. https://doi.org/10.1001/archinte.1992.00400200049009

[8] IARC Working Group on the Evaluation of Carcinogenic Risks to Humans.Biological agents. Volume 100 B. A review of human carcinogens. IARC Monogr Eval Carcinog Risks Hum. 2012; 100(Pt B): 1-441.

[9] Salahuddin SZ, Ablashi DV, Markham PD, et al. Isolation of a new virus, HBLV, in patients with lymphoproliferative disorders. Science. 1986; 234(4776): 596-601. https://doi.org/10.1126/science.2876520

[10] DeFreitas E, Hilliard B, Cheney PR, et al. Retroviral sequences related to human T-lymphotropic virus type II in patients with chronic fatigue immune dysfunction syndrome. Proc Natl Acad Sci USA. 1991; 88(7): 2922-6. https://doi.org/10.1073/pnas.88.7.2922

[11] Levine PH, Pilkington D, Strickland P, et al. Chronic Fatigue Syndrome and Cancer. Journal of Chronic Fatigue Syndrome. 2000; 7(1): 29-38. https://doi.org/10.1300/J092v07n01_04

[12] Grufferman S, Levine PH, Eby NL, et al. Results of an Investigation of Three Clusters of Chronic Fatigue Syndrome. Clinical Infectious Diseases. 1994; 18(Suppl 1): S55-S6.

[13] Patarca-Montero R. Medical Etiology, Assessment, and Treatment of Chronic Fatigue and Malaise: Clinical Differentiation and Intervention; What Does the Research Say? CRC Press; 2004.

[14] Levine PH, Peterson D, McNamee FL, et al. Does chronic fatigue syndrome predispose to non-Hodgkin’s lymphoma? Cancer Research. 1992; 52(Suppl 19): s5516-s8.

[15] Levine PH, Fears TR, Cummings P, et al. Cancer and a fatiguing illness in northern Nevada: a causal hypothesis. Ann Epidemiol. 1998; 8: 245-249. https://doi.org/10.1016/S1047-2797(97)00203-2

[16] Chang CM, Warren JL, Engels EA. Chronic fatigue syndrome and subsequent risk of cancer among elderly U.S. adults. Cancer. 2012; 118(23): 5929-36. PMid:22648858. https://doi.org/10.1002/cncr.27612

[17] Levine PH, Whiteside TL, Friberg D, et al. Dysfunction of natural killer activity in a family with chronic fatigue syndrome. Clin Immunol Immunopathol. 1998; 88(1): 96-104. https://doi.org/10.1006/clin.1998.4554

[18] Aoki T, Miyakoshi H, Usuda Y, et al. Low NK syndrome and its relationship to chronic fatigue syndrome. Clin Immunol Immunopathol. 1993; 69(3): 253-65. https://doi.org/10.1006/clin.1993.1178

[19] Caligiuri M, Murray C, Buchwald D, et al. Phenotypic and functional deficiency of natural killer cells in patients with chronic fatigue syndrome. J Immunol. 1987; 139(10): 3306-13.

[20] Eby NL, Grufferman S, Huang M, et al. Natural killer cell activity in the chronic fatigue-immune dysfunction syndrome. Natural Killer Cells and Host Defense: Karger Publishers; 1989. 141-5 p.

[21] Klimas NG, Salvato FR, Morgan R, et al. Immunologic abnormalities in chronic fatigue syndrome. J Clin Microbiol. 1990; 28(6): 1403-10.

[22] Strickland PS, Levine PH, Peterson DL, et al. Neuromyasthenia and Chronic Fatigue Syndrome (CFS) in Northern Nevada/California. Journal of Chronic Fatigue Syndrome. 2001; 9(3-4): 3-14.

[23] Chi J, Gu B, Zhang C, et al. Human herpesvirus 6 latent infection in patients with glioma. The Journal of Infectious Diseases. 2012; 206(9): 1394-8. PMid:22962688. https://doi.org/10.1093/infdis/jis513

[24] Buchwald D, Cheney PR, Peterson DL, et al. A chronic illness characterized by fatigue, neurologic and immunologic disorders, and active human herpesvirus type 6 infection. Ann Intern Med. 1992; 116(2): 103-13. https://doi.org/10.7326/0003-4819-116-2-103

[25] Lerner AM, Ariza ME, Williams M, et al. Antibody to Epstein-Barr virus deoxyuridine triphosphate nucleotidohydrolase and deoxyribonucleotide polymerase in a chronic fatigue syndrome subset. PloS one. 2012; 7(11): e47891.

[26] Kamel OW, van de Rijn M, Hanasono MM, et al. Immunosuppression-associated lymphoproliferative disorders in rheumatic patients. Leuk Lymphoma. 1995; 16(5-6): 363-8.

[27] Leandro MJ, Isenberg DA. Rheumatic diseases and malignancy-is there an association? Scand J Rheumatol. 2001; 30(4): 185-8. PMid:11578009. https://doi.org/10.1080/030097401316909486

[28] Joncas JH, Chicoine L, Thivierge R, et al. Epstein-barr virus antibodies in the cerebrospinal fluid: A case of infectious mononucleosis with encephalitis. American Journal of Diseases of Children. 1974; 127(2): 282-5. https://doi.org/10.1001/archpedi.1974.02110210132021

[29] Lin CT, Leibovitch EC, Almira-Suarez MI, et al. Human herpesvirus multiplex ddPCR detection in brain tissue from low- and high-grade astrocytoma cases and controls. Infect Agent Cancer. 2016; 11: 32. PMid:27462365. https://doi.org/10.1186/s13027-016-0081-x