Patients who have been previously diagnosed with Hodgkin lymphoma (HL) may be more likely to develop a secondary malignancy than the general population, especially if they have a first-degree relative with cancer, according to a study published in the Journal of Clinical Oncology.
Using the Swedish Family-Cancer Database, researchers analyzed data from 9,522 patients with HL and 28,277 of their relatives. They calculated standardized incidence ratios and cumulative incidence of second cancers in HL survivors, then compared those with incidence of cancers in age- and sex-matched controls. Next, they compared second cancer incidence rates between HL survivors with and without a familial history of cancer. About 30 percent of patients had an immediate relative previously diagnosed with cancer (p<0.001).
The overall risk for second cancers for HL survivors was 2.39 times (95% CI 2.29-2.53; p<0.001) that of controls, and the risk was even higher for patients with a familial history of the disease. The latter had a standardized incidence rate of 2.83 (95% CI 2.58-3.10), which was significantly higher than HL survivors without a familial history (2.16; 95% CI 2.00-2.33; p<0.001). The most common second cancers were mostly non-HL, non-melanoma skin cancers, and tumors in the lung, breast, and bowel.
Age at diagnosis was also associated with the risk of developing a second cancer: Women diagnosed with HL at >34 years had a 3 percent risk of a second cancer, compared with a 14 percent risk for women diagnosed at <35 years.
Limitations of the study include the isolated location of the population.
Source: Sud A, Thomsen H, Sundquist K, et al. Risk of second cancer in Hodgkin lymphoma survivors and influence of family history. J Clin Oncol. 2017 March 13. [Epub ahead of print]