Cancer Survivors Run Greater Risk of Dying from Second Cancers

Adult-onset cancer survivors have an increased risk of developing and dying from subsequent primary cancers (SPCs) than the general population, stated a new American Cancer Society study. The study appears in JAMA.

"These findings highlight the importance of ongoing surveillance and efforts to prevent new cancers among survivors," said lead author, Hyuna Sung, PhD.

‘Cancers linked to smoking or obesity comprised a majority of SPC incidence and mortality among all survivors.’

"The number of cancer survivors who develop new cancers is projected to increase, but, until now, comprehensive data on the risk of SPCs among survivors of adult-onset cancers has been limited."

Researchers analyzed data on nearly 1.54 million cancer survivors from 1992 to 2017 from 12 Surveillance, Epidemiology, and End Results registries in the United States. The cancer survivors examined were between the ages of 20 to 84 (mean age, 60.4 years), 48.8% women, and 81.5% white.

Study Results

• Among the 1,537,101 survivors, 156,442 were diagnosed with an SPC, and 88,818 died of an SPC.
• Male survivors had an 11% higher risk of developing SPCs and a 45% higher risk of dying from SPCs.
• Female survivors had a 10% increased risk of developing SPCs and a 33% higher risk of dying from SPCs.
• Men who survived laryngeal cancer and Hodgkin lymphoma ran the most significant risk of developing an SPC.
• Men who survived gallbladder cancer ran an increased risk of dying from an SPC.
• Among women, cancer survivors of laryngeal and esophageal cancers ran the greatest risk of developing an SPC, and laryngeal cancer survivors also ran the highest risk of SPC mortality.

Smoking risk in subsequent primary cancers' incidence

The study also assessed the prevalence of smoking- and obesity-related cancers in SPC incidence and mortality.

• The risks of smoking-related SPCs were commonly elevated among survivors of smoking-related first cancers.
• Among cancer survivors, four common smoking-related SPCs, including lung, urinary bladder, oral cavity/pharynx, and esophagus, accounted for 26% to 45% of the total SPC incidence and mortality.
• Lung cancer comprised 31% to 33% of the total mortality from SPCs.
• Survivors of many obesity-related cancers had an elevated risk of developing obesity-related SPCs.
• Four common obesity-related cancers colorectum, pancreas, corpus uteri, and liver, comprised 22% to 26% of total SPC mortality.

"These findings reinforce the importance of coordinated efforts by primary care clinicians to mitigate the risks of SPCs through survivorship care, with greater focus on lifestyle factors, including smoking cessation, weight management, physical activity, and healthy eating, as receipt of counseling or treatment (tobacco only) to aid in the adoption of healthy habits," said Ahmedin Jemal, PhD, senior author of the paper.

Source: Medindia