A new study examined men ages 50 to 70 who frequently used the stimulants.

A new study links long-term regular use of poppers with a substantial risk of certain kinds of cancers. The Journal AIDS published a report that examined men who have sex with men (MSM) ages 50 to 70, who were regular users of poppers.

The Multicenter AIDS Cohort Study (MACS) followed 3,223 men (1,563 who were HIV-positive and 1,660 who were negative) for nearly two decades, and found an increased rate of cancers that are caused by viruses, but only among older HIV-negative subjects who were heavy poppers users.

That subset was three times more likely to be diagnosed with a virus-associated cancer—non-Hodgkin lymphoma, Hodgkin lymphoma (caused by EBV), Kaposi’s sarcoma (HHV-8) and anal and oropharyngeal cancer (HPV)—after adjusting for demographics, number of sex partners and other factors.

There was no correlation, however, between men with a large number of sexual partners or with frequent sexually transmitted infections, both of which could have been factors in exposure to viral infections like HPV.

Researchers admit the frequent use of poppers could have made it easier to acquire a cancer-causing virus, “rather than encouraging these cancers to develop by suppressing the immune system,” according to AIDSMaps. (Animal studies have shown amyl nitrate to cause temporary immunosuppression.)

Participants were classified as “light,” “heavy,” or non-users of poppers—heavy use was classified as daily or weekly use for at a one year during the study. Of those without HIV, 20% were identified as heavy users, as compared to 33% of those with HIV.

The publication of the study comes on the heels of a British report linking poppers to permanent vision problems.