Candida infection and cancer risk: A Danish nationwide cohort study

BACKGROUND: Candida species infection may be associated with increased cancer risk. METHODS: We linked data from the nationwide medical registries and examined the incidence of various cancers in patients with a first-time hospital presentation with candida infection. We computed the cumulative incidence of cancer and standardized incidence ratios (SIRs) of cancer overall, immune-related cancers, and specific cancer types by comparing observed versus expected incidences based on age-, sex-, and anatomical site-specific incidence rates. RESULTS: Among 21,247 candida-infected patients, we identified 1534 cancers during a combined follow-up of 187,993years (standardized incidence ratio (SIR)=1.6 (95% confidence interval (CI): 1.5-1.7)). The 1- and 10-year risks of cancer were 2.6%, and 8.3%, respectively. In the first year after a candida diagnosis, the SIR for cancer was 3.7 (95% CI: 3.4-4.0). In the second and subsequent years of follow-up, the SIRs were 1.2 (95% CI: 1.1-1.3) for any cancer and 1.4 (95% CI 1.2-1.7) for immune-related cancers. The risk of mouth and throat cancers remained more than 3-fold increased in the second and subsequent years of follow-up. CONCLUSIONS: Hospital presentation with candida infection is associated with increased short- and long-term cancer risk.