Second primary cancers in non‐Hodgkin lymphoma: Family history and survival

다국어 초록 (Multilingual Abstract)

Second primary cancers (SPCs) account for an increasing proportion of all cancer diagnoses and family history of cancer may be a risk factor for SPCs. Using the Swedish Family‐Cancer Database on non‐Hodgkin lymphoma (NHL), we assessed the influence of family history on risk of SPCs and of SPCs on survival. NHL patients were identified from the years 1958 to 2015 and generalized Poisson models were used to calculate relative risks (RRs) for SPCs and familial SPCs. Among 14,393 NHL patients, a total of 1,866 (13.0%) were diagnosed with SPC. Familial risk of nine particular cancers was associated with risks of these cancers as SPCs, with twofold to fivefold increase in RRs. At the end of a 25‐year follow‐up period, the survival probability for persons with SPC was only 20% of that for patients without SPC; the hazard ratio for SPC was 1.59 (95% CI: 1.46–1.72). Survival could be predicted by the prognostic groups based on first cancers and HRs increase systematically with worse prognosis yielding a trend of p = 4.6 × 10−5. SPCs had deleterious consequences for survival in NHL patients. Family history was associated with increasing numbers of SPCs. Prevention of SPCs and their early detection is an important target in the overall strategy to improve survival in NHL patients. Counseling for avoidance of risk factors and targeted screening based on family history are feasible steps in risk reduction.
What's new?
As more people survive non‐Hodgkin lymphoma (NHL), second primary cancers are becoming more prevalent. In this report, the researchers calculated how family history affected the risk of developing a second primary cancer (SPC), and the effect of SPC on survival, using data from a Swedish database on NHL. Family history of nine cancers translated to risk of developing that cancer as an SPC, increasing the relative risk up to 5‐fold. In addition, NHL survivors who developed a second cancer were far less likely to survive than those who did not. Targeted screening for patients with family history could improve survival.