Survivors of Hodgkin lymphoma with a family history of cancer have a 1.3-fold higher risk of developing a second cancer, according to research published in the Journal of Clinical Oncology (May 2017;35[14]:1584-1590).
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Treatment advancements in Hodgkin lymphoma in recent years have led to improved disease-free survival for patients. However, these advancements — which tend to include chemotherapy and radiotherapy — are accompanied by an increased risk of second cancers, cardiovascular disease, and other treatment-related comorbidities. Moreover, there is a general belief that genetic predispositions in some survivors of Hodgkin lymphoma may also increase their risk of developing a second cancer.
Amit Sud, MBChB, MRes, division of genetics and epidemiology, Institute of Cancer Research (London, England), and colleagues sought to evaluate the risks of developing a second cancer after being cured of Hodgkin lymphoma and to investigate the impact of family history. Using the Swedish Family-Cancer Project Database, researchers identified 9522 patients diagnosed with primary Hodgkin lymphoma between 1965 and 2012, as well as 28277 relatives of these patients. Standardized incidence ratios and cumulative incidence of second cancer in survivors of Hodgkin lymphoma were calculated. Researchers also compared standardized incidence ratios of lung, breast, colorectal, and all second cancers in the survivors with and without a site-specific family history of cancer.
Results of the evaluation showed that survivors of Hodgkin lymphoma experience a 2.39-fold increased risk for developing a second cancer (95% CI, 2.29-2.53). The 30-year cumulative incidence of breast cancer in women aged 35 years or younger diagnosed with Hodgkin lymphoma was 13.8%. No significant difference in cancer risk over successive time periods were observed.
Risk of all second cancers were 1.3-fold higher for survivors of Hodgkin lymphoma who had a first-degree relative with cancer (P < .001), with 3.3-fold, 2.1-fold, and 1.8-fold differences shown for lung, colorectal, and breast cancers, respectively. Additionally, researchers reported a greater than additive interaction between family history of lung cancer and Hodgkin lymphoma treatment (P = .03).
“After patients are cured, they no longer encounter oncologists, so it’s important that other health care providers are aware of the increased risk to Hodgkin lymphoma survivors to improve early diagnosis of second cancers,” said Dr Sud in a press release (May 16, 2017). — Zachary Bessette
