Long-term solid cancer risk among 5-year survivors of Hodgkin's lymphoma

David C Hodgson; Ethel S Gilbert; Graça M Dores; Sara J Schonfeld; Charles F Lynch; Hans Storm; Per Hall; Froydis Langmark; Eero Pukkala; Michael Andersson; Magnus Kaijser; Heikki Joensuu; Sophie D Fosså; Lois B Travis

doi:10.1200/JCO.2006.09.0936

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Long-term solid cancer risk among 5-year survivors of Hodgkin's lymphoma

Journal article

Peer reviewed

Long-term solid cancer risk among 5-year survivors of Hodgkin's lymphoma

David C Hodgson, Ethel S Gilbert, Graça M Dores, Sara J Schonfeld, Charles F Lynch, Hans Storm, Per Hall, Froydis Langmark, Eero Pukkala, Michael Andersson, …

Journal of clinical oncology, Vol.25(12), pp.1489-1497

04/20/2007

DOI: 10.1200/JCO.2006.09.0936

PMID: 17372278

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Abstract

Hodgkin's lymphoma (HL) survivors are known to be at substantially increased risk of solid cancers (SC). However, no investigation has used multivariate modeling to estimate the relative risk (RR), excess absolute risk (EAR), and cumulative incidence for specific attained ages and ages at HL diagnosis. We identified 18,862 5-year HL survivors from 13 population-based cancer registries in North America and Europe. Poisson regression was used to evaluate the effects of age at diagnosis, attained age, latency, sex, treatment, and year of diagnosis on the RR and EAR of SC. Among 1,490 identified SC, 850 were estimated to be in excess. For most cancer sites, both RR and EAR decreased with age at HL diagnosis and showed strong dependencies on attained age. For a patient diagnosed at age 30 years and survived to > or = 40 years, modeled risks were significantly elevated for cancers of the breast (RR = 6.1), other supradiaphragmatic sites (RR = 6.0), and infradiaphragmatic sites (RR = 3.7); the largest RR (20-fold) was observed for malignant mesothelioma. Thirty-year cumulative risks of SC for men and women diagnosed at 30 years were 18% and 26%, respectively, compared with 7% and 9%, respectively, in the general population. For young HL patients, risks of breast and colorectal cancers were elevated 10 to 25 years before the age when routine screening would be recommended in the general population. Multivariable modeling demonstrates for the first time temporal changes in SC risk not evident in unadjusted analyses, and can facilitate the development of individualized risk assessment and the creation of screening strategies for early detection.

Severity of Illness Index

Multivariate Analysis

Age Distribution

Follow-Up Studies

Risk Assessment

Hodgkin Disease - pathology

Humans

Middle Aged

Survivors - statistics & numerical data

Probability

Male

Hodgkin Disease - epidemiology

Incidence

Neoplasms, Second Primary - epidemiology

Disease-Free Survival

Time Factors

Survival Analysis

Sex Distribution

Adult

Female

Poisson Distribution

Registries

Retrospective Studies

Neoplasms, Second Primary - pathology

Details

Title: Subtitle: Long-term solid cancer risk among 5-year survivors of Hodgkin's lymphoma
Creators: David C Hodgson - Princess Margaret Hospital, University Health Network, and the Department of Radiation Oncology, University of Toronto, Canada. David.Hodgson@rmp.uhn.on.ca
Ethel S Gilbert
Graça M Dores
Sara J Schonfeld
Charles F Lynch
Hans Storm
Per Hall
Froydis Langmark
Eero Pukkala
Michael Andersson
Magnus Kaijser
Heikki Joensuu
Sophie D Fosså
Lois B Travis
Resource Type: Journal article
Publication Details: Journal of clinical oncology, Vol.25(12), pp.1489-1497
Publisher: United States
DOI: 10.1200/JCO.2006.09.0936
PMID: 17372278
ISSN: 0732-183X
eISSN: 1527-7755
Grant note: Intramural NIH HHS
Language: English
Date published: 04/20/2007
Academic Unit: Epidemiology
Record Identifier: 9983996079802771

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