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Are rare cancer survivors at elevated risk of subsequent new cancers?
Finkelstein, Dianne M; Horick, Nora K; Ramchandani, Ritesh; Boyd, Kristina L; Rana, Huma Q; Bychkovsky, Brittany L.
Affiliation
  • Finkelstein DM; Massachusetts General Hospital Biostatistics Center & Department of Biostatistics, Harvard T.H. Chan School of Public Health, 50 Staniford Street, Suite 560, Boston, MA, 02114, USA. dfinkelstein@mgh.harvard.edu.
  • Horick NK; Massachusetts General Hospital Biostatistics Center, Boston, MA, USA.
  • Ramchandani R; Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, USA.
  • Boyd KL; Massachusetts General Hospital Biostatistics Center, Boston, MA, USA.
  • Rana HQ; Department of Medicine, Dana-Farber Cancer Institute & Harvard Medical School, Boston, MA, USA.
  • Bychkovsky BL; Department of Medicine, Dana-Farber Cancer Institute & Harvard Medical School, Boston, MA, USA.
BMC Cancer ; 19(1): 166, 2019 Feb 21.
Article in En | MEDLINE | ID: mdl-30791872
BACKGROUND: Although rare cancers account for 27% of cancer diagnoses in the US, there is insufficient research on survivorship issues in these patients. An important issue cancer survivors face is an elevated risk of being diagnosed with new primary cancers. The primary aim of this analysis was to assess whether a history of rare cancer increases the risk of subsequent cancer compared to survivors of common cancers. METHODS: This was a prospective cohort study of 16,630 adults with personal and/or family history of cancer who were recruited from cancer clinics at 14 geographically dispersed US academic centers of the NIH-sponsored Cancer Genetics Network (CGN). Participants' self-reported cancer histories were collected at registration to the CGN and updated annually during follow-up. At enrollment, 14% of participants reported a prior rare cancer. Elevated risk was assessed via the cause-specific hazard ratio on the time to a subsequent cancer diagnosis. RESULTS: After a median follow-up of 7.9 years, relative to the participants who were unaffected at enrollment, those with a prior rare cancer had a 23% higher risk of subsequent cancer (95% CI: -1 to 52%), while those with a prior common cancer had no excess risk. Patients having two or more prior cancers were at a 53% elevated risk over those with fewer than two (95% CI: 21 to 94%) and if the multiple prior cancers were rare cancers, risk was further elevated by 47% (95% CI: 1 to 114%). CONCLUSION: There is evidence suggesting that survivors of rare cancers, especially those with multiple cancer diagnoses, are at an increased risk of a subsequent cancer. There is a need to study this population more closely to better understand cancer pathogenesis.
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Full text: 1 Database: MEDLINE Main subject: Neoplasms, Second Primary / Cancer Survivors / Neoplasms Type of study: Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limits: Adult / Female / Humans / Male / Middle aged Country/Region as subject: America do norte Language: En Journal: BMC Cancer Journal subject: NEOPLASIAS Year: 2019 Type: Article Affiliation country: United States

Full text: 1 Database: MEDLINE Main subject: Neoplasms, Second Primary / Cancer Survivors / Neoplasms Type of study: Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limits: Adult / Female / Humans / Male / Middle aged Country/Region as subject: America do norte Language: En Journal: BMC Cancer Journal subject: NEOPLASIAS Year: 2019 Type: Article Affiliation country: United States