Chang, Cindy M, Warren, Joan L, Engels, Eric A · Cancer · 2012 · DOI
Researchers investigated whether people with ME/CFS have a higher risk of developing cancer. Using medical records from over 1.2 million elderly Americans, they found that people with ME/CFS had a slightly increased risk of non-Hodgkin lymphoma (a blood cancer), particularly certain subtypes. The study does not prove that ME/CFS causes cancer, but suggests that shared immune system problems or infections might explain the connection.
This study provides epidemiological evidence that ME/CFS may be associated with lymphoproliferative disorders, supporting hypotheses that chronic immune dysregulation in ME/CFS could have systemic health consequences. Understanding potential long-term health associations helps inform clinical monitoring and validates the biological relevance of immune abnormalities observed in ME/CFS.
This study demonstrates association, not causation—it does not prove that ME/CFS causes cancer or that cancer causes ME/CFS. The study is limited to elderly Americans (age 66+) and may not generalize to younger ME/CFS patients. Additionally, the very low prevalence of documented CFS in these claims data (0.5%) suggests substantial underdiagnosis, which could introduce bias in either direction.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
The first block is for the primary paper and is the citation you should use in research work. The atlas-snapshot line only applies if you are specifically referring to this atlas’s reading of the paper on the date shown.
Primary citation
Chang, Cindy M, Warren, Joan L, & Engels, Eric A (2012). Chronic fatigue syndrome and subsequent risk of cancer among elderly US adults.. Cancer. https://doi.org/10.1002/cncr.27612
BibTeX
@article{mecfsatlas-chang-2012-chronic-fatigue,
author = {Chang, Cindy M and Warren, Joan L and Engels, Eric A},
title = {Chronic fatigue syndrome and subsequent risk of cancer among elderly US adults.},
journal = {Cancer},
year = {2012},
doi = {10.1002/cncr.27612},
note = {PubMed: 22648858},
url = {https://www.mecfsatlas.com/evidence/chang-2012-chronic-fatigue},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-27. https://www.mecfsatlas.com/evidence/chang-2012-chronic-fatigue
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