Are rare cancer survivors at elevated risk of subsequent new cancers?
Abstract 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...
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| Format: | Article |
| Language: | English |
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BMC
2019-02-01
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| Series: | BMC Cancer |
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| Online Access: | http://link.springer.com/article/10.1186/s12885-019-5358-1 |
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| author | Dianne M. Finkelstein Nora K. Horick Ritesh Ramchandani Kristina L. Boyd Huma Q. Rana Brittany L. Bychkovsky |
| author_facet | Dianne M. Finkelstein Nora K. Horick Ritesh Ramchandani Kristina L. Boyd Huma Q. Rana Brittany L. Bychkovsky |
| author_sort | Dianne M. Finkelstein |
| collection | DOAJ |
| description | Abstract 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. |
| first_indexed | 2024-04-13T11:04:23Z |
| format | Article |
| id | doaj.art-6be071d9587f441da5a812a71b3abdf4 |
| institution | Directory Open Access Journal |
| issn | 1471-2407 |
| language | English |
| last_indexed | 2024-04-13T11:04:23Z |
| publishDate | 2019-02-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Cancer |
| spelling | doaj.art-6be071d9587f441da5a812a71b3abdf42022-12-22T02:49:18ZengBMCBMC Cancer1471-24072019-02-011911610.1186/s12885-019-5358-1Are rare cancer survivors at elevated risk of subsequent new cancers?Dianne M. Finkelstein0Nora K. Horick1Ritesh Ramchandani2Kristina L. Boyd3Huma Q. Rana4Brittany L. Bychkovsky5Massachusetts General Hospital Biostatistics Center & Department of Biostatistics, Harvard T.H. Chan School of Public HealthMassachusetts General Hospital Biostatistics CenterDepartment of Biostatistics, Harvard T.H. Chan School of Public HealthMassachusetts General Hospital Biostatistics CenterDepartment of Medicine, Dana-Farber Cancer Institute & Harvard Medical SchoolDepartment of Medicine, Dana-Farber Cancer Institute & Harvard Medical SchoolAbstract 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.http://link.springer.com/article/10.1186/s12885-019-5358-1Rare cancerSubsequent cancer riskMultiple cancersSurvivorship |
| spellingShingle | Dianne M. Finkelstein Nora K. Horick Ritesh Ramchandani Kristina L. Boyd Huma Q. Rana Brittany L. Bychkovsky Are rare cancer survivors at elevated risk of subsequent new cancers? BMC Cancer Rare cancer Subsequent cancer risk Multiple cancers Survivorship |
| title | Are rare cancer survivors at elevated risk of subsequent new cancers? |
| title_full | Are rare cancer survivors at elevated risk of subsequent new cancers? |
| title_fullStr | Are rare cancer survivors at elevated risk of subsequent new cancers? |
| title_full_unstemmed | Are rare cancer survivors at elevated risk of subsequent new cancers? |
| title_short | Are rare cancer survivors at elevated risk of subsequent new cancers? |
| title_sort | are rare cancer survivors at elevated risk of subsequent new cancers |
| topic | Rare cancer Subsequent cancer risk Multiple cancers Survivorship |
| url | http://link.springer.com/article/10.1186/s12885-019-5358-1 |
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