Adapted from the NCI Cancer Bulletin, vol. 4/no. 13, March 27, 2007 (see the current issue).
Survivors of Hodgkin lymphoma (HL) likely have a significantly increased risk of solid cancers throughout their lives, according to a new study that analyzed several variables influencing risk in this patient population. Results from the international study, published online March 19, 2007, in the Journal of Clinical Oncology, give estimates of risk that can help in risk assessment and screening plans for survivors.
Investigators used data from 18,862 people with HL who had survived for at least five years after diagnosis, collected from the National Cancer Institute's (NCI) Surveillance, Epidemiology, and End Results (SEER) database as well as from four European registries. Variables used in the risk model included sex, year of HL diagnosis, age at HL diagnosis, initial treatment received, and age at diagnosis of solid cancer.
Of the 1,490 solid cancers that were identified, approximately 850 were estimated to be in excess. The risk of developing a solid cancer depended on age at diagnosis of HL, attained age, and sex, with women diagnosed at young ages having the highest risk. The patterns of risk differed between types of solid cancer and the most common sites for excess cancer were the female breast, lungs, and colorectum.
For both colorectal and breast cancers, young HL survivors had absolute risks comparable to those observed in the general population in the age ranges in which screening would normally be recommended (age 50 and above for colorectal screening, age 40 and above for mammography), suggesting that HL survivors would benefit from earlier routine screening.
"This is the first study to quantify the cumulative sex-specific risk of solid cancer for specific ages at Hodgkin lymphoma diagnosis," explains Dr. Ethel Gilbert, from NCI's Division of Cancer Epidemiology and Genetics, one of the authors of the study. "For current survivors, there is a need to investigate interventions to reduce the morbidity and mortality caused by second cancers," conclude the authors.