Second Primary Thyroid Cancer after Hodgkin Lymphoma: A Population-Based Study of 46,988 Hodgkin Lymphoma Survivors

ObjectiveMost studies on second primary malignancies (SPMs) after primary thyroid cancer were conducted in USA or Europe. The discrepancy between SPMs in these studies could be attributed to geographical and ethnic heterogeneity. Thus, there is a clear need for another large-scale epidemiological study, particularly in Asian countries, to define the incidence and risk of SPMs in thyroid cancer survivors.DesignA population-based study was conducted using the nation-wide database from Taiwan Cancer Registry between 1979 and 2006.MethodsWe quantified standardized incidence ratios (SIRs) and cumulative incidence of SPMs among 19 068 individuals (4205 males and 14 863 females) with primary thyroid cancer.ResultsA total of 644 cases (3.38%) developed at least a SPM during 134 678 person-years of follow-up. The risk for subsequent SPMs was significantly greater than that of the general population (SIR=1.33, 95% CI 1.23–1.44). There was a greater risk of developing major salivary glands, nasopharyngeal, lung, thymus, breast (females), bladder, and brain cancers, and leukemia and lymphoma. We observed that the risk was highest within the first 5 years of diagnosis of thyroid cancer (SIR=5.29, 1.68, and 0.68 for ≦5, 5–10, and >10 respectively) and in the younger patients (SIR=1.81 vs 1.61 for <50 and ≧50 respectively). The median overall survival for primary thyroid cancer patients was 23.28 years, but it was only 4.73 years for those who developed SPMs.ConclusionThyroid cancer is associated with a 33% risk increment of SPMs, which had a negative impact on survival. There are sites of SPMs in the Asian population that are distinctive from those in the Western population, suggesting that other genetic predisposition or environmental factors may play a role.

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Second primary malignancies in gastric cancer: A U.S. population-based study.

Journal of Clinical Oncology ◽

10.1200/jco.2015.33.3_suppl.191 ◽

2015 ◽

Vol 33 (3_suppl) ◽

pp. 191-191

Author(s):

Binay Kumar Shah ◽

Amit Khanal

Keyword(s):

Breast Cancer ◽

Prostate Cancer ◽

Gastric Cancer ◽

Thyroid Cancer ◽

Myeloid Leukemia ◽

Population Based ◽

Second Primary ◽

Population Based Study ◽

Gastrointestinal Malignancies ◽

Second Primary Malignancies

191 Background: Risk of second primary malignancies (SPM) is not known in gastric cancer. In this population based study, we analyzed rates of SPM in gastric cancer. Methods: We selected adult (≥18 years) patients with gastric cancer as first primary malignancy diagnosed from January 1992 to December 2011 from Surveillance, Epidemiology and End Result 13 database. We used SEER*stat’s multiple primary standardized incidence ratio (MP-SIR) session to calculate the risk of SPM diagnosed 6 months after the diagnosis of index gastric cancer. Results: Among 31,818 patients with first primary gastric cancer, 1674 (5.26%) developed 1,839 SPM with observed/expected (O/E) ratio of 1.09 (95% CI = 1.05-1.15, p<0.0001) and excess risk of 16.15 per 10,000 population. The median time to first SPM from the time of diagnosis of stomach cancer was 49 months (range 6 months to 19.08 years). There was significantly increased risk of gastrointestinal malignancies [O/E ratio 1.65 (CI=1.53-1.79, p<0.001)], thyroid cancer [O/E ratio 1.98 (CI=1.32-2.84, p<0.01)] and myeloid leukemia [O/E ratio 1.47(CI=1-2.09, p<0.05)]. Interestingly, there was significantly decreased risk of melanoma, breast cancer and prostate cancer. Conclusions: Our study showed that patients with gastric cancer are at higher risk of gastrointestinal malignancies, thyroid cancer and myeloid leukemia. Similarly, risk of melanoma, breast cancer and prostate cancer in patients with gastric cancer is lower than general population.

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Survival after second primary lung cancer following non-Hodgkin lymphoma: A U.S. population-based study.

Journal of Clinical Oncology ◽

10.1200/jco.2014.32.15_suppl.1536 ◽

2014 ◽

Vol 32 (15_suppl) ◽

pp. 1536-1536

Author(s):

LINA INAGAKI ◽

Kevin C. Ward

Keyword(s):

Lung Cancer ◽

Hodgkin Lymphoma ◽

Primary Lung Cancer ◽

Population Based ◽

Second Primary ◽

Population Based Study ◽

Non Hodgkin Lymphoma ◽

Second Primary Lung Cancer

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A population-based study of follow-up care for Hodgkin lymphoma survivors

Cancer ◽

10.1002/cncr.25053 ◽

2010 ◽

Vol 116 (14) ◽

pp. 3417-3425 ◽

Cited By ~ 31

Author(s):

David C. Hodgson ◽

Eva Grunfeld ◽

Nadia Gunraj ◽

Lisa Del Giudice

Keyword(s):

Hodgkin Lymphoma ◽

Population Based ◽

Population Based Study ◽

Follow Up Care ◽

Lymphoma Survivors

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Second primary head and neck cancer after Hodgkin lymphoma: A population-based study of 44,879 survivors of Hodgkin lymphoma

Cancer ◽

10.1002/cncr.29231 ◽

2015 ◽

Vol 121 (9) ◽

pp. 1436-1445 ◽

Cited By ~ 10

Author(s):

Amit K. Chowdhry ◽

Colin McHugh ◽

Chunkit Fung ◽

Sughosh Dhakal ◽

Louis S. Constine ◽

...

Keyword(s):

Head And Neck Cancer ◽

Head And Neck ◽

Hodgkin Lymphoma ◽

Neck Cancer ◽

Population Based ◽

Second Primary ◽

Population Based Study

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Role of oncologists and primary care physicians in providing follow-up care to non-Hodgkin lymphoma survivors within 5 years of diagnosis: a population-based study

Supportive Care in Cancer ◽

10.1007/s00520-013-2113-z ◽

2014 ◽

Vol 22 (6) ◽

pp. 1509-1517 ◽

Cited By ~ 8

Author(s):

Laura P. Forsythe ◽

Neeraj K. Arora ◽

Catherine M. Alfano ◽

Kathryn E. Weaver ◽

Ann S. Hamilton ◽

...

Keyword(s):

Primary Care ◽

Hodgkin Lymphoma ◽

Primary Care Physicians ◽

Population Based ◽

Population Based Study ◽

Non Hodgkin Lymphoma ◽

Follow Up Care ◽

Lymphoma Survivors

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Second Hematologic Malignancies After Radioiodine Exposure In Patients With Thyroid Cancer and The Relationship With Radioiodine Dosage: A Nationwide Population-Based Study

Blood ◽

10.1182/blood.v122.21.1375.1375 ◽

2013 ◽

Vol 122 (21) ◽

pp. 1375-1375

Author(s):

Chia-Jen Liu ◽

Man-Hsin Hung ◽

Chung-Jen Teng ◽

Yu-Wen Hu ◽

Yi-Ping Hung ◽

...

Keyword(s):

Thyroid Cancer ◽

Dose Response ◽

Hematologic Malignancies ◽

Population Based ◽

Second Primary ◽

Population Based Study ◽

Increased Risk ◽

Clear Dose Response ◽

Second Primary Malignancies

Abstract Background Second primary malignancies are one of the most important late effects after radioactive iodine (RAI) exposure, which is widely used in the diagnosis and treatment for thyroid cancers. However, dose-response correlation between RAI and second hematologic malignancies (SHM) was not established. Therefore, we conducted a nationwide population-based study to investigate the risk of SHM among thyroid cancer patients and the association between RAI dosage and development of SHM, including leukemia. Material and methods We recruited patients with newly diagnosed thyroid cancer aged 20 years or older without antecedent cancer from the Taiwan National Health Insurance database between 1997 and 2010. The standardized incidence ratios (SIR) of cancers were calculated to compare the cancer incidence of thyroid cancer patients to the general population according to gender, calendar year, and age in 5-year intervals by the corresponding stratum-specific person-time accrued in the cohort. The association of cumulative RAI dosage and development of SHM, including leukemia, was estimated using time-dependent analysis with 2-year latent period. Results After exclusion of first-year follow-up, 692 second primary malignancies developed among 20,235 patients with thyroid cancer, with a follow-up of 134,178 person-years. Fifty SHM developed with a SIR of 2.37 (95% confidence interval 1.76-3.13). The significant increased risk of SHM included: leukemia (SIR, 2.74; 95% CI, 1.65-4.28), non-Hodgkin lymphoma (SIR, 2.38; 95% CI, 1.55-3.48). As a time-dependent covariate with a 2-year latent period, RAI significantly increased the risk of leukemia with a clear dose-response correlation (age- and sex-adjusted hazard ratio per 100 mCi increase, 1.10; 95% CI, 1.01-1.19, P = 0.032). This effect was not seen in other second primary malignancies. Conclusions Our study reveals increased risk of SHM among patients with thyroid cancer. RAI increases the risk of leukemia with a clear dose-response relationship. Disclosures: No relevant conflicts of interest to declare.

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