IARC 60th Anniversary - 19-21 May 2026
Session : 20/05/26 - Posters
Effect of cytomegalovirus infection on aerodigestive cancer mortality
MURISON K. 1,2, BURCHELL A. 2,3,4, AVERY L. 2,5, LIU G. 2,6, HUNG R. 1,2
1 Lunenfeld-Tanenbaum Research Institute, Sinai Health, Toronto, Canada; 2 Dalla Lana School of Public Health, University of Toronto, Torono, Canada; 3 Department of Family and Community Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada; 4 MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Unity Health Toronto, Toronto, Canada; 5 Department of Biostatistics, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada; 6 Department of Medical Oncology and Hematology, Princess Margaret Cancer Centre, United Health Network, Toronto, Canada
Background
Cytomegalovirus (CMV) is a common herpesvirus that establishes lifelong infection and is linked to increased mortality in several immunocompromised populations. Currently, CMV status is tested at diagnosis of hematological malignancy to optimize patient care. However, its role in the prognosis of solid tumors remains poorly understood.
Objectives
To evaluate whether CMV infection at the time of cancer diagnosis impacts overall survival for patients with aerodigestive tract cancers, and to evaluate whether immune and inflammatory blood markers modify this association.
Methods
This analysis included lung and head and neck (HN) cancer cases enrolled in the Multicancer Case-Control Study at Mount Sinai Hospital and Princess Margaret Cancer Centre (MSH-PMH) between 2008 and 2014. CMV infection status at diagnosis was determined using baseline serology testing. Overall survival was defined as time from cancer diagnosis to death or last follow-up. Cox proportional hazards models were fit to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for the association between CMV infection (ever vs. never) and survival, adjusting for potential confounders. Routinely collected blood cell measures, including derived inflammatory ratios such as the neutrophil–lymphocyte ratio (NLR), were evaluated using laboratory values at baseline for effect measure modification.
Results
Among 500 lung and 500 HN cancer patients, 370 (74%) and 275 (55%) had serological evidence of CMV infection at diagnosis, respectively, with 24 being classified as a secondary (reactivation) infection and 1 being classified as primary. CMV infection was not significantly associated with overall survival in lung (HR: 0.79; 95% CI: 0.59–1.05) or HN patients (HR: 1.11; 95% CI: 0.68–1.79). Results did not differ by subgroup when stratifying on immune markers indicating higher vs. lower levels of inflammation (NLRHigh HR: 1.97; 95% CI: 0.56–6.86; NLRLow HR: 1.11; 95% CI: 0.36–3.44), or by immune competence (e.g. lymphocyte count) (LymphocyteHigh HR: 1.14; 95% CI: 0.39–3.34; LymphocyteLow HR: 1.59; 95% CI: 0.45–5.63). Similar results were seen in lung cancer patients.
Conclusions/Implications
CMV infection was not significantly associated with survival of patients with aerodigestive tract cancer. Further investigation related to possible CMV-related effects on prognosis through immune modulation is ongoing.