scholarly journals Cancer incidence in a cohort of Swedish merchant seafarers between 1985 and 2011

2022 ◽  
Author(s):  
Karl Forsell ◽  
Ove Björ ◽  
Helena Eriksson ◽  
Bengt Järvholm ◽  
Ralph Nilsson ◽  
...  
Keyword(s):  
Lung Cancer ◽  
General Population ◽  
Cancer Incidence ◽  
Urinary Bladder Cancer ◽  
Increased Risk ◽  
Total Cancer ◽  
Observation Times ◽  
Risk Of Cancer ◽  
Occupational Settings ◽  
Swedish Cohort

Abstract Purpose Lung cancer, mesothelioma and several lifestyle-associated cancer forms have been reported more common in merchant seafarers. However, few studies reflect recent occupational settings and women seafarers are usually too scarce for meaningful analyses. We conducted a study on cancer incidence between 1985 and 2011 in a Swedish cohort consisting of male and female seafarers. Methods All seafarers in the Swedish Seafarers’ Register with at least one sea service between 1985 and 2011 and a cumulated sea service time of ≥ 30 days (N = 75,745; 64% men, 36% women; 1,245,691 person-years) were linked to the Swedish Cancer Register and followed-up until 31 December 2011. Standardized incidence ratios (SIR) were calculated with the general population as reference. Results There were 4159 cancer cases in total, with 3221 among men and 938 among women. Male seafarers had an increased risk of total cancer (SIR 1.05; 95% CI 1.01–1.09), lung cancer (SIR 1.51; 95% CI 1.35–1.67) and urinary bladder cancer (SIR 1.17; 95% CI 1.02–1.33). Several lifestyle-associated cancer forms were more common in men. Previous work on tankers was associated with leukaemia (SIR 1.41; 95% CI 1.00–1.86). The risk of cancer decreased with a start as a male seafarer after 1985, with a significant trend for total cancer (P < 0.001), lung cancer (P = 0.001) and, for tanker seafarers, leukaemia (P = 0.045). Women seafarers had an increased risk of lung cancer (SIR 1.54; 95% CI 1.23–1.87) but the risk of total cancer was not increased (SIR 0.83; 95% CI 0.78–0.89). Conclusions In this cohort of merchant Swedish seafarers 1985–2011, the risk of total cancer was increased in men but not in women compared to the general population. Lung cancer was increased in both genders. The risk of cancer seems to decrease over the last decades, but better exposure assessments to occupational carcinogens and longer observation times are needed.

scholarly journals Serum Uric Acid Increases Risk of Cancer Incidence and Mortality: A Systematic Review and Meta-Analysis

2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
Shushan Yan ◽  
Pengjun Zhang ◽  
Wei Xu ◽  
Yuqing Liu ◽  
Bin Wang ◽  
...  
Keyword(s):  
Cancer Incidence ◽  
Meta Analysis ◽  
Positive Association ◽  
Epidemiological Studies ◽  
Protective Role ◽  
Increased Risk ◽  
Incidence And Mortality ◽  
Total Cancer ◽  
Risk Of Cancer

SUA is a potent antioxidant and thus may play a protective role against cancer. Many epidemiological studies have investigated this hypothesis but provided inconsistent and inconclusive findings. We aimed to precisely elucidate the association between SUA levels and cancer by pooling all available publications. Totally, 5 independent studies with 456,053 subjects and 12 with 632,472 subjects were identified after a comprehensive literature screening from PubMed, Embase, and Web of Science. The pooled RRs showed that individuals with high SUA levels were at an increased risk of total cancer incidence (RR=1.03, 95% CI 1.01–1.05,P=0.007). Positive association between high SUA levels and total cancer incidence was observed in males but not females (for men:RR=1.05, 95% CI 1.02–1.08,P=0.002; for women,RR=1.01, 95% CI 0.98–1.04,P=0.512). Besides, high SUA levels were associated with an elevated risk of total cancer mortality (RR=1.17, 95% CI 1.04–1.32,P=0.010), particularly in females (RR=1.25, 95% CI 1.07–1.45,P=0.004). The study suggests that high SUA levels increase the risk of total cancer incidence and mortality. The data do not support the hypothesis of a protective role of SUA in cancer.

scholarly journals Colorectal and Other Cancer Risks for Carriers and Noncarriers From Families With a DNA Mismatch Repair Gene Mutation: A Prospective Cohort Study

2012 ◽  
Vol 30 (9) ◽  
pp. 958-964 ◽  
Author(s):  
Aung Ko Win ◽  
Joanne P. Young ◽  
Noralane M. Lindor ◽  
Katherine M. Tucker ◽  
Dennis J. Ahnen ◽  
...  
Keyword(s):  
General Population ◽  
Mismatch Repair ◽  
Gene Mutation ◽  
Urinary Bladder Cancer ◽  
Female Breast Cancer ◽  
Mismatch Repair Gene ◽  
Cancer Risks ◽  
Repair Gene ◽  
Increased Risk ◽  
Risk Of Cancer

Purpose To determine whether cancer risks for carriers and noncarriers from families with a mismatch repair (MMR) gene mutation are increased above the risks of the general population. Patients and Methods We prospectively followed a cohort of 446 unaffected carriers of an MMR gene mutation (MLH1, n = 161; MSH2, n = 222; MSH6, n = 47; and PMS2, n = 16) and 1,029 their unaffected relatives who did not carry a mutation every 5 years at recruitment centers of the Colon Cancer Family Registry. For comparison of cancer risk with the general population, we estimated country-, age-, and sex-specific standardized incidence ratios (SIRs) of cancer for carriers and noncarriers. Results Over a median follow-up of 5 years, mutation carriers had an increased risk of colorectal cancer (CRC; SIR, 20.48; 95% CI, 11.71 to 33.27; P < .001), endometrial cancer (SIR, 30.62; 95% CI, 11.24 to 66.64; P < .001), ovarian cancer (SIR, 18.81; 95% CI, 3.88 to 54.95; P < .001), renal cancer (SIR, 11.22; 95% CI, 2.31 to 32.79; P < .001), pancreatic cancer (SIR, 10.68; 95% CI, 2.68 to 47.70; P = .001), gastric cancer (SIR, 9.78; 95% CI, 1.18 to 35.30; P = .009), urinary bladder cancer (SIR, 9.51; 95% CI, 1.15 to 34.37; P = .009), and female breast cancer (SIR, 3.95; 95% CI, 1.59 to 8.13; P = .001). We found no evidence of their noncarrier relatives having an increased risk of any cancer, including CRC (SIR, 1.02; 95% CI, 0.33 to 2.39; P = .97). Conclusion We confirmed that carriers of an MMR gene mutation were at increased risk of a wide variety of cancers, including some cancers not previously recognized as being a result of MMR mutations, and found no evidence of an increased risk of cancer for their noncarrier relatives.

scholarly journals Cancer incidence after childhood irradiation for tinea capitis in a Portuguese cohort

2020 ◽  
Vol 93 (1105) ◽  
pp. 20180677
Author(s):  
Luís Antunes ◽  
Maria José Bento ◽  
Manuel Sobrinho-Simões ◽  
Paula Soares ◽  
Paula Boaventura
Keyword(s):  
Radiation Dose ◽  
General Population ◽  
Cancer Risk ◽  
Radiation Exposure ◽  
Head And Neck ◽  
Cancer Incidence ◽  
Tinea Capitis ◽  
Incidence Rates ◽  
Increased Risk ◽  
Risk Of Cancer

Objectives: Our aim was to compare cancer incidence in a cohort exposed in childhood (1950–63) to a therapeutic dose of radiation in the North of Portugal and followed-up until the end of 2012, with the incidence rates for the same age and sex in the general population. Methods: A population-based North Region cancer registry (RORENO) was used to assess which members of the cohort developed cancer. The association between radiation exposure and overall and specific cancer sites was evaluated using standardised incidence ratios (SIR). Results: Over the full follow-up period, 3357 individuals of the 5356 original tinea capitis (TC) cohort (63%) were retrieved in the RORENO, and 399 new cancer cases were identified, representing an increased risk of 49% when compared with the general population (SIR = 1.49; 95% CI: 1.35–1.64). The risk was slightly higher in males than in females (SIR = 1.65; 95% CI: 1.43–1.89 vs SIR = 1.35; CI = 1.17–1.55). The risk was slightly higher in the individuals exposed to a higher radiation dose (SIR = 1.78; 95% CI: 1.22–2.51 for ≥630 R vs SIR = 1.46; 95% CI: 1.31–1.62 for 325–475 R). In females, there was an excess cancer risk in all cancers with the higher radiation dose (SIR = 2.00; 95% CI: 1.21–3.13 for ≥630 R vs SIR = 1.30; 95% CI: 1.11–1.51 for 325–475 R) which was not observed in males, and for combined dose categories significantly raised SIRs for thyroid and head and neck cancer, suggesting a possible higher radiosensitivity of females. An increased risk was also observed for some cancers located far from the irradiated area. Conclusions: The results suggest an association between radiation exposure and later increased cancer risk for cancers located near the radiation exposed area, mainly thyroid, and head and neck cancers. Further studies are necessary to disentangle possible non-radiation causes for distant cancers increased risk. Advances in knowledge: This paper shows a possible association between childhood X-ray epilation and increased risk of cancer which was not previously investigated in the Portuguese TC cohort.

Prediction of 10-year and lifetime risk of cancer in individual patients with established cardiovascular disease, results from UCC-SMART and CANTOS

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
C.C Van 't Klooster ◽  
P.M Ridker ◽  
N.R Cook ◽  
J.G.J.V Aerts ◽  
J Westerink ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Risk Factors ◽  
Lung Cancer ◽  
Cancer Risk ◽  
Prediction Models ◽  
Funding Source ◽  
Cancer Models ◽  
Total Cancer ◽  
The Cantos ◽  
Risk Of Cancer

Abstract Background As treatment for cardiovascular disease (CVD) has improved substantially over the last decades, more patients survive acute CVD manifestations and are at risk for developing cancer as well as recurrent CVD. Due to similar risk factors, including smoking and obesity, patients with established CVD are at higher risk for cancer. Objectives The aim of this study was to develop and externally validate prediction models for the estimation of 10-year and lifetime risk for total, colorectal, and lung cancer in patients with established CVD. Methods Data from patients with established CVD from the UCC-SMART prospective cohort study (N=7,280) were used for model development, and data from the CANTOS trial (N=9,322) were used for model validation. Predictors were selected based on previously published cancer risk prediction models or cancer risk factors, easy clinical availability, and availability in the derivation dataset (UCC-SMART cohort). A Fine and Gray competing risk-adjusted lifetime model was developed for total, colorectal, and lung cancer. Results Selected predictors were age, sex, smoking status, weight, height, alcohol use, antiplatelet use, diabetes mellitus, and C-reactive protein. External calibration for 4-year risks of the total cancer, colorectal cancer, and lung cancer models was good (Figure 1), and C-statistics were 0.63–0.74 in the CANTOS trial population. Median predicted lifetime risks in CANTOS were 26% (range 1%-52%) for total cancer, 4% (range 0%-13%) for colorectal cancer, and 5% (range 0%-37%) for lung cancer. Conclusions Lifetime and 10-year risk of cancer can be estimated with easy to measure variables in patients with established CVD, showing a wide distribution of predicted lifetime risks for total cancer and lung cancer. Using these lifetime models in clinical practice could increase understanding of cancer risk and aid in emphasizing healthy lifestyle changes. Figure 1. Calibration plots of cancer models Funding Acknowledgement Type of funding source: Public hospital(s). Main funding source(s): University Medical Center; Additional funding: CANTOS trial was funded by Novartis Pharmaceuticals.

Relationship between alcohol consumption and cancer in rural Chinese adults: 1 5- year follow-up cohort study

2020 ◽  
Author(s):  
Yue Zhang ◽  
Jingyi Li ◽  
Nannan Cheng ◽  
Jie Yang ◽  
Lijing Ye ◽  
...  
Keyword(s):  
Cohort Study ◽  
Alcohol Consumption ◽  
Cancer Incidence ◽  
Rural China ◽  
Density Lipoprotein ◽  
Estimating Equation ◽  
Chinese Adults ◽  
Increased Risk ◽  
Risk Of Cancer

Abstract Background：We aimed to evaluate the association between alcohol consumption and risk of cancer incidence among rural Chinese adults. Methods: We utilized data from a community-based cohort study in rural China enrolled in 2003 and followed up prospectively up to 2018. Generalized estimating equation models were used to obtain odds ratios (OR) and 95% confidence intervals (CI) to analyze the relationship between alcohol consumption and cancer incidence. Results: After an average of 15 years of follow-up, a total of 9870 adult participants were included in this study. The results of the regression analysis for males showed that former drinkers had a significantly increased risk of cancer compared to never drinkers ([OR]2.46,95%[CI](1.43-4.23)). The cancer risk for current drinkers with heavy alcohol consumption(>400g/week) significantly increased ([OR]1.66,95% [CI] (1.18-2.34))compared to never drinkers. Among current drinkers, for every 100g of alcohol consumed per week, the risk of cancer increased by 15%. Among current drinkers, those aged 53.5 years or older , had a significant increase in the risk of cancer ([OR]1.26,95% [CI](1.12-1.42), for those with triglycerides ≥150 mg/dL, the risk of cancer was even higher ([OR]1.50,95%[CI](1.20-1.88), P for interaction 0.018), and for those with high density lipoprotein cholesterol (HDLC)<40 mg/dL, the risk of cancer increased the greatest ([OR]2.03,95%[CI](1.36-3.04), P for interaction 0.005). Conclusions: Among middle-aged and elderly males in rural China, the risk of cancer significantly increased among former and heavy current drinkers compared with never drinkers. Age, triglycerides, and HDLC may increase the risk of cancer along with alcohol consumption.

scholarly journals Association between Six Environmental Chemicals and Lung Cancer Incidence in the United States

2011 ◽  
Vol 2011 ◽  
pp. 1-9 ◽  
Author(s):  
Juhua Luo ◽  
Michael Hendryx ◽  
Alan Ducatman
Keyword(s):  
Lung Cancer ◽  
Cancer Incidence ◽  
Environmental Science ◽  
The United States ◽  
Environmental Chemicals ◽  
Lung Cancer Incidence ◽  
Industrial Chemicals ◽  
Individual Level ◽  
Increased Risk ◽  
Seer Data

Background.An increased risk of lung cancer has been observed at exposure to certain industrial chemicals in occupational settings; however, less is known about their carcinogenic potential to the general population when those agents are released into the environment.Methods.We used the Toxics Release Inventory (TRI) database and Surveillance, Epidemiology, and End Results (SEER) data to conduct an ecological study at the county level. We used multiple linear regression to assess the association of age-adjusted lung cancer incidence with the quantities of on-site air and water releases of six selected industrial chemicals including arsenic, 1,3 butadiene, cadmium, chromium, formaldehyde, and nickel after controlling for other risk variables.Results.Overall, we observed a significantly increased risk of lung cancer incidence associated with releases of chromium, formaldehyde, and nickel. The links were present for both males and females. Significant effects were present in nonmetropolitan but not metropolitan counties. Releases of arsenic, 1,3 butadiene, and cadmium were reported by small numbers of facilities, and no relationships to lung cancer incidence were detected.Conclusions.Our results suggest that environmental exposure to chromium, formaldehyde, and nickel from TRI sites may increase population risk of lung cancer. These findings need to be confirmed in individual-level studies, but in congruence with the precautionary principle in environmental science, support prudent efforts to limit release of these agents into the environment.

scholarly journals Cancer Incidence in Patients With Acromegaly: A Cohort Study and Meta-Analysis of the Literature

2018 ◽  
Vol 103 (6) ◽  
pp. 2182-2188 ◽  
Author(s):  
Jakob Dal ◽  
Michelle Z Leisner ◽  
Kasper Hermansen ◽  
Dóra Körmendiné Farkas ◽  
Mads Bengtsen ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Colorectal Cancer ◽  
Cohort Study ◽  
Cancer Incidence ◽  
Meta Analysis ◽  
Population Based ◽  
Incidence Rates ◽  
Tract Cancer ◽  
Increased Risk ◽  
Risk Of Cancer

Abstract Context Acromegaly has been associated with increased risk of cancer morbidity and mortality, but research findings remain conflicting and population-based data are scarce. We therefore examined whether patients with acromegaly are at higher risk of cancer. Design A nationwide cohort study (1978 to 2010) including 529 acromegaly cases was performed. Incident cancer diagnoses and mortality were compared with national rates estimating standardized incidence ratios (SIRs). A meta-analysis of cancer SIRs from 23 studies (including the present one) was performed. Results The cohort study identified 81 cases of cancer after exclusion of cases diagnosed within the first year [SIR 1.1; 95% confidence interval (CI), 0.9 to 1.4]. SIRs were 1.4 (95% CI, 0.7 to 2.6) for colorectal cancer, 1.1 (95% CI, 0.5 to 2.1) for breast cancer, and 1.4 (95% CI, 0.6 to 2.6) for prostate cancer. Whereas overall mortality was elevated in acromegaly (SIR 1.3; 95% CI, 1.1 to 1.6), cancer-specific mortality was not. The meta-analysis yielded an SIR of overall cancer of 1.5 (95% CI, 1.2 to 1.8). SIRs were elevated for colorectal cancer, 2.6 (95% CI, 1.7 to 4.0); thyroid cancer, 9.2 (95% CI, 4.2 to 19.9); breast cancer, 1.6 (1.1 to 2.3); gastric cancer, 2.0 (95% CI, 1.4 to 2.9); and urinary tract cancer, 1.5 (95% CI, 1.0 to 2.3). In general, cancer SIR was higher in single-center studies and in studies with &lt;10 cancer cases. Conclusions Cancer incidence rates were slightly elevated in patients with acromegaly in our study, and this finding was supported by the meta-analysis of 23 studies, although it also suggested the presence of selection bias in some earlier studies.

Risk Of Solid Subsequent Malignant Neoplasms (SMNs) With Extended Follow-Up Of Childhood Hodgkin Lymphoma (HL) Survivors Is Comparable To The Risk In Known High-Risk Groups Within The General Population: Report From The Late Effects Study Group (LESG)

Blood ◽  
2013 ◽  
Vol 122 (21) ◽  
pp. 2992-2992
Author(s):  
Smita Bhatia ◽  
Cor van den Bos ◽  
Can-Lan Sun ◽  
Jillian Birch ◽  
Lisa Diller ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Colorectal Cancer ◽  
Lung Cancer ◽  
High Risk ◽  
General Population ◽  
Clin Oncol ◽  
Cumulative Incidence ◽  
Risk Groups ◽  
Increased Risk

Abstract Background We describe the pattern and incidence of SMNs with 10 additional years of follow-up of an international cohort (Bhatia, N Engl J Med, 1996; Bhatia, J Clin Oncol, 2003) of children with HL diagnosed between 1955 and 1986 at age 16 y or younger. Methods Medical record review was used to identify SMNs, define vital status and describe therapeutic exposures. Pathology reports served to validate SMNs. Cumulative incidence (CI) utilized competing risk methods. Standardized incidence ratio (SIR) and absolute excess risk (AER/10,000 p-y) utilized age-, gender- and year-matched rates in the general population. Cox regression techniques (using calendar time as time scale) identified predictors of SMN risk. Results The cohort included 1023 patients diagnosed with HL at a median age of 11 y, and followed for a median of 26.8 y (IQR, 16.4-33.7). Eighty-nine percent had received radiation, either alone (22%), or in combination with chemotherapy (67%). Alkylating agent (AA) score was defined as follows: 1 AA for 6 m = AA score of 1; 2 AA for 6 m or 1 AA for 12 m = AA score of 2, etc. The AA score was 1-2 for 54% and 3+ for 16%; 30% did not receive AA. A total of 188 solid SMNs developed in 139 patients (breast [54], thyroid [24], lung [11], colorectal [11], bone [8], other malignancies [80]. Table summarizes SIR (95%CI), CI, and AER by attained age. The cohort was at an 11.1-fold increased risk of developing solid SMNs (excluding non-melanoma skin cancers) compared with the general population (95% CI, 9.4-13.0). CI of solid SMNs was 25.2% at 40 y from HL diagnosis (Fig 1). Among patients aged ≥40 y, 79% of total AER was attributable to breast, thyroid, colorectal and lung SMNs (Table). Thirty-seven patients developed >1 solid SMN; the cumulative incidence of the 2nd SMN was 19.6% at 10 years from diagnosis of the 1st SMN. Breast Cancer: Females (n=41) had a 20.9-fold increased risk, and males (n=3) a 45.8-fold increased risk c/w general population. Age at HL of 10-16 y vs. <10 y (RR=9.7, 95%CI, 2.3-40.6, p=0.002), and exposure to chest radiation (RR=5.9, 95%CI, 1.4-25.9) were associated with increased risk. Among females aged 10-16 y at chest radiation, cumulative incidence was 24.3% by age 45 y, as opposed to 2.6% for those <10 y, p=0.001 (Fig 2). Exposure to AA was associated with a lower risk (RR=0.4, p=0.002). Diagnosis of HL after 1975 was associated with decreased risk (RR=0.25, 95%CI 0.12-0.53), explained, in part by the increasing use of AA after 1975 (78%) vs. before 1975 (61%). By age 40 y, the risk of breast cancer among females exposed to chest radiation at age 10-16 y (18.2%) was comparable to the risk for BRCA1 mutation carriers (15%-20% by age 40 y; Chen, J Clin Oncol, 2007). Lung cancer: Ten of 11 lung cancer cases were diagnosed in males (males: SIR=24.7; females: SIR=3.2, p=0.05); all had received neck/chest radiation. The CI of lung cancer among males was 3.8% by age 50 y, comparable to the risk among male smokers (2% by age 50 y, Bilello, Clinics Chest Med, 2002). Colorectal cancer: There was a 11.5-fold increased risk c/w general population. The CI among those with abdominal/pelvic radiation was 4.1% by age 50 y ; this risk is higher than that observed in individuals with ≥2 first degree relatives affected with colorectal cancer (1.2% by age 50 y, Butterworth, Eur J Cancer, 2006). Thyroid cancer: Survivors had a 22.2-fold increased risk; all developed within radiation field. Females (RR=4.3, 95%CI 1.8-10.4) were at increased risk. Conclusion In this cohort of HL survivors with 20,344 p-y of follow-up, the greatest excess risk of SMNs among those > 40 y was attributable to breast, thyroid, colorectal and lung SMNs. Observed risks for the most common SMNs were comparable to or greater than known high-risk groups within the general population. Disclosures: No relevant conflicts of interest to declare.

scholarly journals De Novo Cancer Incidence after Kidney Transplantation in South Korea from 2002 to 2017

2021 ◽  
Vol 10 (16) ◽  
pp. 3530
Author(s):  
Boyeon Kim ◽  
Minjin Kang ◽  
Yoonjung Kim ◽  
Hyung Soon Lee ◽  
Banseok Kim ◽  
...  
Keyword(s):  
Kidney Transplantation ◽  
South Korea ◽  
Cancer Incidence ◽  
Proportional Hazards ◽  
De Novo ◽  
Cancer Development ◽  
National Database ◽  
Monitoring Methods ◽  
Increased Risk ◽  
Risk Of Cancer

Advances in patient care and immunosuppressive drugs have improved graft survival, resulting in an increase in kidney transplantation (KT); however, persistent immunosuppression is thought to cause late occurrence of cancer. This population-based study consisted of a total of 14,842 patients whose data from the years 2002 to 2017 were collected from the National Health Information Database in South Korea. Malignancies occurred in 7.6% of the total KT patients. Prostate and thyroid cancers were the most common in males and females, respectively. From the age-adjusted incidence analysis, Kaposi’s sarcoma showed the highest standardized incidence ratio in both male and female patients. According to the linear regression model, cancer incidence in KT recipients under immunosuppressive conditions increased by approximately 0.1% each month. Patients’ age over 39 and the use of prednisolone as an initial steroid regimen were associated with increased risk of cancer development after KT. Our regression and proportional hazards models will help clinicians to predict the approximate cancer incidence risk when monitoring KT recipients. Based on the largest available national database, screening or monitoring methods for cancer detection and prevention can be established for KT patients by considering the factors involved in cancer development.

scholarly journals Cancer Incidence in Sickle Cell Disease:an Institutional Experience

Blood ◽  
2018 ◽  
Vol 132 (Supplement 1) ◽  
pp. 1087-1087
Author(s):  
Shivi Jain ◽  
Andrew Srisuwananukorn ◽  
Santosh L. Saraf ◽  
Xu Zhang ◽  
Jin Han ◽  
...  
Keyword(s):  
General Population ◽  
Sickle Cell ◽  
Control Cohort ◽  
University Of Illinois ◽  
Incidence Of Cancer ◽  
Solid Malignancies ◽  
Increased Risk ◽  
The University ◽  
And Control ◽  
Risk Of Cancer

Abstract Background. The incidence of cancer in sickle cell disease (SCD) is of substantial interest since life expectancy of SCD patients has improved with 85-94%SCD patients surviving to adulthood1and the risk of cancer increases with advancing age. A limited number of case reports and surveys have suggested an increased risk of cancer in the SCD population. Two large population based studies have recently examined the incidence of cancer in the SCD population. Goldacre et al. reported an increased incidence of hematologic cancers and some solid tumors among 7512 SCD patients in England compared with patients hospitalized for minor medical and surgical conditions2. Wun et al. reported that compared to the general population, SCD patients had a 72% increased risk of hematologic malignancies and a 38% reduced risk of solid tumors3 Methods. We studied the incidence of cancer in SCD at the University of Illinois at Chicago (UIC) in a retrospective cohort study that identified SCD patients and cancer cases using ICD-9-CM codes. The study included SCD patients, all ages, seen at UIC between September 30, 2010 and September 30, 2015. An age, gender, race and ethnicity matched non-SCD cohort was selected from the general population of UIC patients from the same time frame. The incidence of cancer was compared between the SCD and non-SCD UIC patient cohorts. The study was approved by the Institutional Review Board. The data was provided by the University of Illinois Hospital and Health Sciences System Clinical Research Data Warehouse and stored in secure Redcap database. Results. There were 1327 patients in the SCD cohort, 41.8% males and 58.1% females. The breakdown by ethnicity was 94.8% African Americans (AA), 4.8 % other and 0.38% white patients as shown in Fig.1. There were 23 cancer cases identified in the SCD cohort (1.25%). The electronic medical records of all these cancers cases were reviewed to verify the cancer diagnosis. Amongst the cancer cases identified in SCD cohort there were 5 patients (22.7%) on hydroxyurea (HU) and 17 (77.3%) were not on HU. There were 8 (34.8%) hematological and 15 (65.2%) solid malignancies in the SCD Cohort as shown in Table1.There were 5295 patients in the control cohort, with breakdown by gender and race was identical to the SCD cohort. There were 87 cancer cases identified in this cohort (1.6%). There were 12 (13.8%) hematologic and 48 (55.2%) solid malignancies of the total cancers in control cohort. Fischer exact test was used to compare the cancer incidence in the SCD and control cohorts. Our study did not show statistically significant differences between the SCD and control cohorts for the incidence of total cancers (p=0.81) and solid tumors (p=0.87). There was increased incidence of AML and total hematological malignancies in SCD cohort and the difference was statistically different between SCD and control cohort (p=0.04) as shown in Table 2. Discussion. To the best of our knowledge this is the only study where instead of relying on the registry and billing codes the SCD and cancer diagnosis was manually verified in the SCD cohort to maximally eliminate any inaccuracies in estimation of incidence. Goldacre et al. used hospitalization data in England and reported a threefold to 10-fold higher incidence of hematologic cancers among SCD patients and an increased risk for colon cancer, nonmelanoma skin cancer, kidney cancer, and thyroid cancer. Wun et al. reported increased risk of leukemia and low risk of solid cancers based on hospital admission and emergency department (ED) data, so healthier SCD patients, particularly children, may have been excluded. Our study data is not limited to inpatient and ED department and includes patients of all ages. Our study shows that overall the cancer rates of those with sickle cell disease are not significantly different from the general population. There is increased incidence of hematological malignancies but the sample size is small. Nevertheless, due to treatment advances including hematopoietic stem cell transplant, increased awareness and better access to health care patients with SCD are living longer and there is a need to screen SCD patients for cancer just as vigilantly as for non-SCD patients. Reference.Maitra P,Ataga KI, Hematologica 102(4):626-636.(apr 2017)Olena O Seminog, Michael J Goldacre, Journal of the Royal Society of Medicine; 2016, Vol. 109(8) 303-309Ann Brunson,Ted Wun,Blood Volume 130 Number 13(September 2017) Disclosures No relevant conflicts of interest to declare.

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