Cancer survivors at greater risk of developing subsequent cancers

Dec. 23, 2020

A study from the American Cancer Society suggests that adult-onset cancer survivors run a greater risk of developing and dying from subsequent primary cancers (SPCs) than the general population. Cancers associated with smoking or obesity comprised a majority of SPC incidence and mortality among all survivors, according to a press release.

The study appears in JAMA.

For the study, investigators 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 survivors analyzed were between the ages of 20 to 84.

The findings suggest that among the 1,537,101 survivors, 156,442 were diagnosed with an SPC and 88,818 died of an SPC. Results found that male survivors had an 11 percent higher risk of developing SPCs and a 45 percent higher risk of dying from SPCs compared with the risk in the general population. Female survivors had a 10 percent higher risk of developing SPCs and a 33 percent higher risk of dying from SPCs.

The investigators found men who survived laryngeal cancer and Hodgkin lymphoma ran the greatest risk of developing an SPC, while men who survived gallbladder cancer ran the greatest risk of dying from an SPC. Among women, survivors of laryngeal and esophageal cancers ran the greatest risk of developing an SPC, and laryngeal cancer survivors also ran the greatest risk of SPC mortality.

Substantial variation existed in the associations of specific types of first cancers with specific types of SPC risk.

Results suggest the risks of smoking-related SPCs were commonly elevated among survivors of smoking-related first cancers. Among survivors of all cancers, four common smoking-related SPCs including lung, urinary bladder, oral cavity/pharynx, and esophagus, accounted for 26 percent to 45 percent of the total SPC incidence and mortality. Furthermore, lung cancer alone comprised 31 percent to 33 percent of the total mortality from SPCs.

Similarly, survivors of many obesity-related cancers had an elevated risk of developing obesity-related SPCs. Among survivors of all cancers, four common obesity-related cancers colorectum, pancreas, corpus uteri, and liver, comprised 22 percent to 26 percent of total SPC mortality.

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