Marley, Jennifer, Nicholl, Barbara I, Macdonald, Sara et al. · Journal of multimorbidity and comorbidity · 2021 · DOI
This study looked at whether people with certain long-term health conditions are more likely to develop cancers of the food pipe or stomach. Researchers followed nearly 488,000 UK adults for about 7 years and found that people with conditions like chronic fatigue syndrome, Barrett's oesophagus, and some other diseases had higher rates of these cancers. The findings suggest doctors should be more aware of these connections when assessing cancer risk in their patients.
This study identifies chronic fatigue syndrome as independently associated with increased stomach cancer risk, a finding that warrants clinical attention and further investigation into potential shared mechanisms or confounding factors. For ME/CFS patients, these findings underscore the importance of establishing appropriate cancer screening protocols and understanding whether the condition itself, associated lifestyle factors, or comorbidities drive the elevated risk.
This study demonstrates association, not causation—chronic fatigue syndrome may be a marker for other unmeasured factors that increase cancer risk, or reverse causation is possible (early cancer symptoms could be misdiagnosed as CFS). The findings rely on self-reported diagnoses and are specific to the UK Biobank population; results may not generalize to other populations or ethnic groups. The biological mechanisms linking CFS to stomach cancer remain unexplored.
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
Marley, Jennifer, Nicholl, Barbara I, Macdonald, Sara, Mair, Frances S, & Jani, Bhautesh D (2021). Associations between long-term conditions and upper gastrointestinal cancer incidence: A prospective population-based cohort of UK Biobank participants.. Journal of multimorbidity and comorbidity. https://doi.org/10.1177/26335565211056136
BibTeX
@article{mecfsatlas-marley-2021-associations-between,
author = {Marley, Jennifer and Nicholl, Barbara I and Macdonald, Sara and Mair, Frances S and Jani, Bhautesh D},
title = {Associations between long-term conditions and upper gastrointestinal cancer incidence: A prospective population-based cohort of UK Biobank participants.},
journal = {Journal of multimorbidity and comorbidity},
year = {2021},
doi = {10.1177/26335565211056136},
note = {PubMed: 34820338},
url = {https://www.mecfsatlas.com/evidence/marley-2021-associations-between},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-29. https://www.mecfsatlas.com/evidence/marley-2021-associations-between
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