Assessment of Clinical Risk Factors for Symptomatic Venous Thromboembolism in Common Cancers: A VERITY Registry Study

Abstract The association between venous thromboembolism (VTE) and cancer is well-recognised, but the thrombosis risk factor profile of patients with cancer-associated VTE is poorly characterised; it is unclear if additional risk factors contribute to the risk of thrombosis beyond the cancer itself, or if the risk factor profile is tumour-specific. Our aim was to compare the thrombosis risk factor profiles of cancer patients with or without symptomatic VTE enrolled in VERITY, an ongoing UK prospective VTE registry. The VERITY registry records data on patients with VTE and those in whom the diagnosis of VTE is excluded. Between Jun 05 and Mar 08, 49044 patient entries were made. Individual case data for patients with cancer were extracted. Using available risk factor data, univariate analysis of 9 established risk factors for VTE (medical in-patient history/immobilisation >3 days within last 4 weeks; major surgery in the last 4 weeks; hormonal risk factor; previous history of VTE; family history of VTE; known thrombophilia; intravenous drug abuse; current smoking; and leg paralysis), comparing VTE and non-VTE cancer cases, was performed for the 4 most common cancers using SPSS. To account for the potential impact of age and sex on VTE risk, age-adjusted values were calculated for breast and prostate cancer, and age- and sex-adjusted values for colorectal and lung. A nominal level of 5% statistical significance was assumed. Of 2825 cancer cases, 1382 had an objectively confirmed diagnosis of VTE and in 1443 the diagnosis of VTE was excluded. Breast (n=498), prostate (n=374), colorectal (n=343) and lung cancer (n=275) accounted for 53% of cancer cases. Univariate associations between risk factors and symptomatic VTE were found only for prostate cancer: history of VTE (odds ratio [OR] = 3.48; 95% CI, 2.01, 6.02; p < 0.00001), family history of VTE (OR = 2.56; 95% CI, 1.02, 6.44; p = 0.046), hormonal risk factor (OR = 2.22; 95% CI, 1.00, 4.92; p = 0.049). In colorectal cancer, smoking was less likely in VTE cases (OR = 0.54; 95% CI, 0.34, 0.87; p = 0.012). Adjusting for age (and sex), univariate associations between risk factors and symptomatic VTE were again found only for prostate cancer: history of VTE (OR = 3.23; 95% CI, 1.56, 6.68; p = 0.002), with smoking less likely in age-adjusted VTE cases (OR = 0.50; 95% CI, 0.28, 0.91; p = 0.022). Our analysis of a registry population found few associations between known thrombosis risk factors and symptomatic VTE in patients with common cancers, suggesting these factors impact little on thromboembolic risk in these cancers.

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Abstract P292: Cardiovascular Risk Factors in U.S. Men With and Without History of Prostate Cancer: NHANES 1999-2014

Circulation ◽

10.1161/circ.137.suppl_1.p292 ◽

2018 ◽

Vol 137 (suppl_1) ◽

Author(s):

Ahmed A Hassoon ◽

Lawrence Appel ◽

Hsin-Chieh Yeh

Keyword(s):

Prostate Cancer ◽

Risk Factors ◽

Cancer Survivors ◽

Odds Ratio ◽

Cvd Risk Factors ◽

Cvd Risk ◽

Prevalence Odds Ratio ◽

Cancer History ◽

Prostate Cancer Survivors ◽

History Of

In 2017 161,000 new cases of prostate cancer diagnosed in the U.S. With improved survival from prostate cancer, cardiovascular disease has emerged as competing cause of morbidity and mortality. However, few studies have assessed CVD risk factors among prostate cancer survivors. We analyzed National Health and Nutrition Examination Survey (NHANES) from 1999-2014 to assess CVD risk factors, as defined by AHA/ACC, in adult men with and without a history of prostate cancer. A total of 602 men, age 50 years and older, with prostate cancer history and 8,226 men without cancer history were included in the analysis. Among men with prostate cancer history, the mean (SE) age at survey was 72.3(0.4); 41% of the survivors had their diagnoses less than 5 years ago, while 31% survived more than 10 years after diagnosis. Compared to men without cancer, prostate cancer survivors were older (mean age 72 (0.4) vs 62y (0.1)), but with similar education level ( p =0.41). For CVD risk factors, prostate cancer survivors were less likely to be current smokers (6.5% vs 20.3%), but more likely to have hypertension and on anti-hypertensive medication (95.6% vs 88.9%) with age-adjusted prevalence odds ratio of 1.53 ([95% CI, 1.2 - 1.9]; p =0.001) and 1.78 ([95% CI, 1.1 - 2.9]; p =0.024), respectively. There were no differences in lipids profiles between men with and without prostate cancer. In stratified analysis, non-Hispanic blacks’ survivors have almost two times the prevalence of hypertension compared to non-Hispanic blacks free of cancer, with age-adjusted prevalence odds ratio of 1.9 ([95% CI, 1.2 - 2.96]; p=0.005). In conclusion, CVD risk factors were prevalent in prostate cancer survivors. Improving cardiovascular health through lifestyle change and preventive strategies is a public health priority, particularly among non-Hispanic Blacks.

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Multi-cohort modeling strategies for scalable globally accessible prostate cancer risk tools

BMC Medical Research Methodology ◽

10.1186/s12874-019-0839-0 ◽

2019 ◽

Vol 19 (1) ◽

Author(s):

Johanna Tolksdorf ◽

Michael W. Kattan ◽

Stephen A. Boorjian ◽

Stephen J. Freedland ◽

Karim Saba ◽

...

Keyword(s):

Prostate Cancer ◽

Risk Factors ◽

Family History ◽

Cancer Risk ◽

Risk Prediction ◽

Prostate Biopsy ◽

Prostate Cancer Risk ◽

High Grade ◽

Prediction Tools ◽

History Of

Abstract Background Online clinical risk prediction tools built on data from multiple cohorts are increasingly being utilized for contemporary doctor-patient decision-making and validation. This report outlines a comprehensive data science strategy for building such tools with application to the Prostate Biopsy Collaborative Group prostate cancer risk prediction tool. Methods We created models for high-grade prostate cancer risk using six established risk factors. The data comprised 8492 prostate biopsies collected from ten institutions, 2 in Europe and 8 across North America. We calculated area under the receiver operating characteristic curve (AUC) for discrimination, the Hosmer-Lemeshow test statistic (HLS) for calibration and the clinical net benefit at risk threshold 15%. We implemented several internal cross-validation schemes to assess the influence of modeling method and individual cohort on validation performance. Results High-grade disease prevalence ranged from 18% in Zurich (1863 biopsies) to 39% in UT Health San Antonio (899 biopsies). Visualization revealed outliers in terms of risk factors, including San Juan VA (51% abnormal digital rectal exam), Durham VA (63% African American), and Zurich (2.8% family history). Exclusion of any cohort did not significantly affect the AUC or HLS, nor did the choice of prediction model (pooled, random-effects, meta-analysis). Excluding the lowest-prevalence Zurich cohort from training sets did not statistically significantly change the validation metrics for any of the individual cohorts, except for Sunnybrook, where the effect on the AUC was minimal. Therefore the final multivariable logistic model was built by pooling the data from all cohorts using logistic regression. Higher prostate-specific antigen and age, abnormal digital rectal exam, African ancestry and a family history of prostate cancer increased risk of high-grade prostate cancer, while a history of a prior negative prostate biopsy decreased risk (all p-values < 0.004). Conclusions We have outlined a multi-cohort model-building internal validation strategy for developing globally accessible and scalable risk prediction tools.

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Abstract NS6: Family History of Stroke: Invisibility of a Key Stroke Risk Factor among High Risk African Americans

Stroke ◽

10.1161/str.44.suppl_1.ans6 ◽

2013 ◽

Vol 44 (suppl_1) ◽

Author(s):

Dawn M Aycock ◽

Kenya D Kirkendoll ◽

Kisha C Coleman ◽

Karen C Albright ◽

Anne W Alexandrov

Keyword(s):

Risk Factors ◽

Risk Factor ◽

Family History ◽

Perceived Control ◽

Stroke Risk ◽

Perceived Threat ◽

Stroke Risk Factor ◽

Stroke Risk Factors ◽

History Of ◽

Physiologic Data

Background & Purpose: Young to middle aged African Americans (AA) are at greater risk for a first-ever stroke, severe neurologic disability, and stroke-related mortality, than Caucasians of similar age; however, it remains unclear what role a family history of stroke (FHS) plays in promoting adoption of healthier lifestyles in this cohort. The purpose of this study was to explore differences between rural Stroke Belt AA with a FHS (e.g. parent/grandparent/sibling) on modifiable stroke risk factors, knowledge, perceived threat and perceived control of stroke, and exercise behaviors to AA without a FHS. Methods: A cross-sectional study was conducted recruiting AA aged 19-54 from the Black Belt region of Alabama via a mobile health clinic. Participants’ perceptions, knowledge, exercise history/intent, physiologic data, and health history were recorded. Results: Participants (N=66) averaged 43.3+9.4 years, were 71% female, with at least 12 years of school (89%), and unemployed (62%). Common risk factors were insufficient exercise (76%), obesity (59%), hypertension (53%; blood pressure M=145+17.6/88.3+12.9), and cigarette smoking (38%). Participants with a FHS (n=33) did not differ on average number of risk factors compared to those without a FHS (FHS 2.8+1.4 vs. 2.2+1.5; t(64)= 1.73, p=.089), nor did they differ on physiologic data. However, participants with a FHS were more likely to report a history of hypertension (67%) compared to those without a FHS (33%; χ2 =4.93, p <.05). There were no significant differences between groups for knowledge of stroke risk factors, perceived threat and perceived control of stroke, or recent exercise performance, although participants with a FHS (3.4+1.2) had significantly lower future intentions to exercise compared to those without a FHS (3.9+0.8); t(64)=2.45, p<.05). Conclusions: Although FHS is a significant non-modifiable risk factor for stroke and was common in this young to middle-aged AA cohort, FHS did not drive perceived stroke risk, risk factor control, or current/future intentions to exercise. Identification of interventions designed to personalize FHS as a key stroke risk factor, while promoting lifestyle change and self-management, may play an important role in future primary stroke prevention.

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Prevalence of germline BRCA mutations in HER2-negative metastatic breast cancer: global results from the real-world, observational BREAKOUT study

Breast Cancer Research ◽

10.1186/s13058-020-01349-9 ◽

2020 ◽

Vol 22 (1) ◽

Cited By ~ 1

Author(s):

Joyce O’Shaughnessy ◽

Christine Brezden-Masley ◽

Marina Cazzaniga ◽

Tapashi Dalvi ◽

Graham Walker ◽

...

Keyword(s):

Breast Cancer ◽

Risk Factors ◽

Ovarian Cancer ◽

Risk Factor ◽

Metastatic Breast Cancer ◽

Family History ◽

Metastatic Breast ◽

Cytotoxic Chemotherapy ◽

First Line ◽

History Of

Abstract Background The global observational BREAKOUT study investigated germline BRCA mutation (gBRCAm) prevalence in a population of patients with human epidermal growth factor receptor 2 (HER2)-negative metastatic breast cancer (MBC). Methods Eligible patients had initiated first-line cytotoxic chemotherapy for HER2-negative MBC within 90 days prior to enrollment. Hormone receptor (HR)-positive patients had experienced disease progression on or after prior endocrine therapy, or endocrine therapy was considered unsuitable. gBRCAm status was determined using baseline blood samples or prior germline test results. For patients with a negative gBRCAm test, archival tissue was tested for somatic BRCAm and homologous recombination repair mutations (HRRm). Details of first-line cytotoxic chemotherapy were also collected. Results Between March 2017 and April 2018, 384 patients from 14 countries were screened and consented to study enrollment; 341 patients were included in the full analysis set (median [range] age at enrollment: 56 [25–89] years; 256 (75.3%) postmenopausal). Overall, 33 patients (9.7%) had a gBRCAm (16 [4.7%] in gBRCA1 only, 12 [3.5%] in gBRCA2 only, and 5 [1.5%] in both gBRCA1 and gBRCA2). gBRCAm prevalence was similar in HR-positive and HR-negative patients. gBRCAm prevalence was 9.0% in European patients and 10.6% in Asian patients and was higher in patients aged ≤ 50 years at initial breast cancer (BC) diagnosis (12.9%) than patients aged > 50 years (5.4%). In patients with any risk factor for having a gBRCAm (family history of BC and/or ovarian cancer, aged ≤ 50 years at initial BC diagnosis, or triple-negative BC), prevalence was 10.4%, versus 5.8% in patients without these risk factors. HRRm prevalence was 14.1% (n = 9/64) in patients with germline BRCA wildtype. Conclusions Patient demographic and disease characteristics supported the association of a gBRCAm with younger age at initial BC diagnosis and family history of BC and/or ovarian cancer. gBRCAm prevalence in this cohort, not selected on the basis of risk factors for gBRCAm, was slightly higher than previous results suggested. gBRCAm prevalence among patients without a traditional risk factor for harboring a gBRCAm (5.8%) supports current guideline recommendations of routine gBRCAm testing in HER2-negative MBC, as these patients may benefit from poly(ADP-ribose) polymerase (PARP) inhibitor therapy. Trial registration NCT03078036.

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A logistic regression analysis of risk factors in ME/CFS pathogenesis

BMC Neurology ◽

10.1186/s12883-019-1468-2 ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 1

Author(s):

Eliana M. Lacerda ◽

Keith Geraghty ◽

Caroline C. Kingdon ◽

Luigi Palla ◽

Luis Nacul

Keyword(s):

Risk Factors ◽

Multiple Sclerosis ◽

Regression Analysis ◽

Risk Factor ◽

Family History ◽

Disease Onset ◽

Healthy Controls ◽

Lower Income ◽

Wide Range ◽

History Of

Abstract Background Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) is a complex disease, whose exact cause remains unclear. A wide range of risk factors has been proposed that helps understanding potential disease pathogenesis. However, there is little consistency for many risk factor associations, thus we undertook an exploratory study of risk factors using data from the UK ME/CFS Biobank participants. We report on risk factor associations in ME/CFS compared with multiple sclerosis participants and healthy controls. Methods This was a cross-sectional study of 269 people with ME/CFS, including 214 with mild/moderate and 55 with severe symptoms, 74 people with multiple sclerosis (MS), and 134 healthy controls, who were recruited from primary and secondary health services. Data were collected from participants using a standardised written questionnaire. Data analyses consisted of univariate and multivariable regression analysis (by levels of proximity to disease onset). Results A history of frequent colds (OR = 8.26, P <= 0.001) and infections (OR = 25.5, P = 0.015) before onset were the strongest factors associated with a higher risk of ME/CFS compared to healthy controls. Being single (OR = 4.41, P <= 0.001), having lower income (OR = 3.71, P <= 0.001), and a family history of anxiety is associated with a higher risk of ME/CFS compared to healthy controls only (OR = 3.77, P < 0.001). History of frequent colds (OR = 6.31, P < 0.001) and infections before disease onset (OR = 5.12, P = 0.005), being single (OR = 3.66, P = 0.003) and having lower income (OR = 3.48, P = 0.001), are associated with a higher risk of ME/CFS than MS. Severe ME/CFS cases were associated with lower age of ME/CFS onset (OR = 0.63, P = 0.022) and a family history of neurological illness (OR = 6.1, P = 0.001). Conclusions Notable differences in risk profiles were found between ME/CFS and healthy controls, ME/CFS and MS, and mild-moderate and severe ME/CFS. However, we found some commensurate overlap in risk associations between all cohorts. The most notable difference between ME/CFS and MS in our study is a history of recent infection prior to disease onset. Even recognising that our results are limited by the choice of factors we selected to investigate, our findings are consistent with the increasing body of evidence that has been published about the potential role of infections in the pathogenesis of ME/CFS, including common colds/flu.

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Effectiveness of tablet family history collection in a multidisciplinary pancreatic tumor clinic in identifying patients with risk factors for hereditary cancer.

Journal of Clinical Oncology ◽

10.1200/jco.2017.35.15_suppl.e13020 ◽

2017 ◽

Vol 35 (15_suppl) ◽

pp. e13020-e13020

Author(s):

Jessica Everett ◽

Kara Schradle ◽

Heather Cameron ◽

Anisha Patel ◽

Erika Koeppe ◽

...

Keyword(s):

Risk Factors ◽

Family History ◽

Pancreatic Tumor ◽

Treatment Options ◽

Cancer History ◽

Referral Criteria ◽

Counseling And Testing ◽

Standard Family ◽

Family Cancer History ◽

History Of

e13020 Background: A substantial percentage of patients with pancreatic adenocarcinoma (PDAC) harbor pathogenic germline variants in known cancer risk genes, some with relevance for treatment options. Robust collection of relevant personal and family cancer history risk factors for all patients with PDAC is needed to optimize identification of those who could benefit from genetic counseling and testing (GC/GT). Methods: 464 adult patients (≥18 years of age) presenting to a multi-disciplinary pancreatic tumor clinic were invited to complete a tablet based family cancer history survey prior to their clinic appointments. Standard family history entry into electronic medical record (EMR) was reviewed for comparison. Eight GC/CT referral criteria were developed based on existing guidelines for known syndromes associated with PDAC, reported findings from studies of GC/GT outcomes in patients with PDAC, and expert opinion. Presence of any of the 8 criteria were documented for both tablet and EMR collection methods in the subset of patients with PDAC (n = 230). Results: Completion rate for the tablet survey was high (87%). 78% of users completed the survey in ≤15 minutes (x̄ = 12 minutes). 202 patients with PDAC (88%) completed the tablet survey, and 100 (50%) met ≥1 GC/GT criteria. Most frequent criteria identified were: ≥2 relatives with related cancers (28%); ≥1 relative with PDAC (12.9%); personal history of related cancer (12.9%). Tablet data collection improved identification of relatives with breast cancer ca < age 50 from 1.5% to 5.5% due to missing ages at diagnosis in the EMR. The tablet survey also identified 12 patients with Ashkenazi Jewish (AJ) ancestry (6%), a risk factor not accounted for in EMR. Conclusions: Tablet based family cancer history collection is well accepted by patients and easily integrated into clinic work flow. The tablet survey found GC/GT criteria in 50%, and improved identification of key risk factors for BRCA1/2 mutation (AJ ancestry, relative with breast ca < age 50). Further work should focus on integration of tablet based survey data into EMR, and decision support tools to optimize referral and follow through with genetic services.

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Family history of myocardial infarction is an independent risk factor for venous thromboembolism: the Tromsø study

Journal of Thrombosis and Haemostasis ◽

10.1111/j.1538-7836.2008.03102.x ◽

2008 ◽

Vol 6 (11) ◽

pp. 1851-1857 ◽

Cited By ~ 69

Author(s):

S. K. BRAEKKAN ◽

E. B. MATHIESEN ◽

I. NJØLSTAD ◽

T. WILSGAARD ◽

J. STØRMER ◽

...

Keyword(s):

Myocardial Infarction ◽

Risk Factor ◽

Venous Thromboembolism ◽

Family History ◽

Independent Risk Factor ◽

History Of

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Misanian Men, are or aren't a Prostatic Adenocarcinoma?

ASM Science Journal ◽

10.32802/asmscj.2020.502 ◽

2021 ◽

Vol 14 ◽

pp. 1-4

Author(s):

Haider Qasim Alhelfi

Keyword(s):

Prostate Cancer ◽

Diabetes Mellitus ◽

Risk Factor ◽

Family History ◽

Prostatic Carcinoma ◽

Screening Program ◽

High Grade ◽

History Of ◽

Male Patients ◽

Oncology Center

It is an observational study in Al-Shafaa Oncology Center in Misan province about male patients with prostatic carcinoma to make an idea about the prevalence of this malignancy. This study was carried out during the period from July 2018 to March 2019 in Al-Shafaa Oncology Center in Al-Sadder teaching hospital in Misan province in which 53 male patients were involved. In our study we found that that the disease reaching a peak among patients between (70-80) years, (66.03%) of patients are a smoker (13.2%), had a family history of different type of cancer, (100%) of the patients had adenocarcinoma, (56.6%) that had high-grade cancer (Gleason score ˃8), (77.35%) of the patient had PSA level >100 ng/ml. The prostate cancer in Misan appears to be more likely to occur in the presence of particular risk factor like age, hypertension, family history, and less likely in the presence of diabetes mellitus. It is more likely to be presented with high grade and metastatic disease, and this may be primarily explained by the absence of the screening program.

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Screening of Hemoglobin A1c in Gestational Diabetes among women attending metabolic clinic at a tertiary care hospital in Uttar Pradesh

Asian Journal of Medical Sciences ◽

10.3126/ajms.v10i2.22578 ◽

2019 ◽

Vol 10 (2) ◽

pp. 26-30

Author(s):

Vivek Sinha ◽

Poonam Kachhawa

Keyword(s):

Diabetes Mellitus ◽

Risk Factors ◽

Risk Factor ◽

Family History ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Pregnant Women ◽

P Value ◽

Close Monitoring ◽

History Of

Background: Gestational diabetes mellitus (GDM) is a common medical condition that complicates pregnancies..Gestational diabetes mellitus (GDM) is a diabetic metabolic disorder that occurs in 4% of all pregnant women and 14% of ethnic groups with more prevalence of type II diabetes. It can be defined as increased or abnormal insulin resistance, decreased insulin sensitivity or glucose intolerance with first diagnosis during pregnancy. Aims and Objectives: The purpose of this study was to evaluate the diagnostic screening value of the HbA1c, prevalence of GDM and associated risk factors. Materials and Methods: The study was conducted at the metabolic clinic; in the department of Biochemistry located at SIMS, Hapur. A semi-structured pretested questionnaire was used for data collection. Following the DIPSI guidelines, patients with plasma glucose values >140 mg/dl were labeled as GDM. Statistical methods used were OR (CI95%), percentage, Chi square. Results: Out of 500, 6.72% had GDM. Among all GDM patients, 64.71% had age more than 30 years, 70.59% had BMI more than 25, 41.18% had gravida more than 3 and p- value was significant with regard to age and BMI. P value was found to be significant for risk factors namely positive family history of Diabetes Mellitus, history of big baby and presence of more than one risk factor. Conclusion: GDM is associated with high BMI, early pregnancy loss, family history of DM and previous history of big baby and there could be more than one risk factor. Thus universal screening followed by close monitoring of the pregnant women for early detection of GDM may help improving maternal and fetal outcomes.

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Association of second primary malignancies with past and family history of malignancy in patients with small cell lung cancer.

Journal of Clinical Oncology ◽

10.1200/jco.2012.30.15_suppl.e17526 ◽

2012 ◽

Vol 30 (15_suppl) ◽

pp. e17526-e17526

Author(s):

Keisuke Kirita ◽

Koichi Goto ◽

Shigeki Umemura ◽

Kiyotaka Yoh ◽

Seiji Niho ◽

...

Keyword(s):

Risk Factors ◽

Risk Factor ◽

Family History ◽

Malignant Disease ◽

Past History ◽

Significant Risk ◽

Second Primary ◽

Thoracic Cancer ◽

History Of ◽

Second Primary Malignancies

e17526 Background: Based on recent development in the treatment for small cell lung cancer (SCLC) such as chemotherapy and radiotherapy, long-term survivors are frequently observed. Meanwhile, etoposide and radiotherapy, which are key treatments for SCLC, are also known as methods to set up late complication including carcinogenicity. There have been few reports of second primary malignancies (SPM) in patients with SCLC, and risk factor for SPM has not become evident other than smoking continuation. Methods: From July 1992 to December 2009, 900 patients with SCLC were treated in National Cancer Center Hospital East. Medical records of all patients were retrospectively reviewed, and the incidence and risk factor for SPM were investigated. Results: Demographics of all patients with SCLC were as follows: Male/Female, 738/162; median age, 66 years (range 22-87); smoking pack-year (PY) <30/30≤, 155/745; Limited/Extensive, 468/432. Median follow up time was 4.5 years. Three and 5-year overall survival rate were 16.4% and 11.6%, respectively. Twenty-seven patients (3.0%) developed SPM, 15 patients (54%) of whom died due to SPM. Thoracic cancer occupied 52% of them (lung, 11; trachea, 1; esophagus, 4; breast, 1). Three and 5-year cumulative incidence rate (CIR) of SPM were 2.5% and 11.8%. Although there was no significant risk factor for SPM, the groups having past history of malignant disease and heavy smoker (PY ≥30) tended to develop SPM (p=0.11and 0.07). Using etoposide containing regimen and thoracic irradiation were not significant risk factors for the incidence of SPM (p=0.84 and 0.24). Neither serum level of CEA, NSE nor ProGRP were risk factors of incidence of SPM (p=0.51, 0.09 and 0.21). Within over 2-year survivors, there was a significant correlation between family history of cancer within first-degree relatives and CIR of SPM (p<0.01). Conclusions: Five years CIR of SPM was 11.6%, and secondary thoracic cancer accounted for large portion of them. It was concluded that cumulative smoking amount, past history of malignant disease, and positive family history of cancer within first-degree relatives were risk factors for SPM.

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