Cytomegalovirus and Lung Cancer: Evidence Beyond Any Reasonable Doubt?

Background: Human cytomegalovirus (HCMV) has been detected in various cancers, including lung adenocarcinoma. However, whether HCMV represents a sufficient condition for EGFR-mutated lung cancer remains unclear. This study re-analyses data from Harabajsa et al. (2023) to evaluate the relationship between HCMV infection and EGFR-mutated lung adenocarcinoma. Material and methods: We applied the Empirical Proportion Test (EPT), a nonparametric, parameter-free test based on a discrete uniform reference distribution over all possible success counts. The analysis included 67 patients with EGFR-mutated lung adenocarcinoma, all of whom tested positive for HCMV (\ (k = 67\), \ (n = 67\) ). The right-tailed p-value was calculated under the null hypothesis that HCMV is not a sufficient condition. Results: The EPT without threshold yielded a right-tailed p-value of \ (1/68 = 0. 0147\). The exact binomial test with \ (₀ = 0. 95\) produced a p-value of \ (0. 0322\). Both tests reject the null hypothesis at \ (= 0. 05\). Conclusion: With an error probability of \ (p = 0. 03\), we conclude that HCMV is a sufficient condition for EGFR-mutated lung cancer. This finding suggests that HCMV may be causally involved in lung cancer development.