Second primary malignant neoplasms (SPMs) are a well-known late effect of first cancers, and a new study published in JAMA Oncology shows that younger patients may have a higher risk of mortality from these cancers, compared with older patients.
In this population-based, retrospective cohort study, researchers analyzed data for patients diagnosed with cancer between 1992 and 2008. Patients were divided into three groups:
- adolescents and young adults (AYAs; 15-39 years old; n=125,750)
- children (<15 years; n=15,954)
- older adults (≥40 years; n=878,370)
Data was collected from 13 Surveillance, Epidemiology, and End Results (SEER) regions in the United States.
Analysis showed that 5-year survival rates with SPMs were lower than with first disease across all age groups. However, they were substantially lower for pediatric and AYA patients, compared with older adults. Survival rates were 33.1 percent lower for pediatric patients, 20.2 percent lower for adolescent adults, and 8.3 percent lower for older adults.
For the most common SPMs in AYA patients, the absolute difference in 5-year survival rates were:
- 42% lower for secondary non-Hodgkin lymphoma
- 19% lower for secondary breast carcinoma
- 15% lower for secondary thyroid carcinoma
- 13% lower for secondary soft-tissue sarcoma
The authors concluded that the adverse effects of SPMs may provide an explanation for why survival among AYAs has not improved to the same degree as patients in other age groups.
Study limitations include variance in the regionalized data.
Source: Keegan T, Bleyer A, Rosenberg A, et al. Second primary malignant neoplasms and survival in adolescent and young adult cancer survivors. JAMA Oncol. 2017 April 20. [Epub ahead of print]