A new study from the American Cancer Society has found that Survivors of adult-onset cancer are at increased risk of developing later primary cancers (CPP) and die from them than the general population. Cancers associated with smoking or obesity account for the majority of the incidence and mortality of CPP among all survivors, as published in the journal ‘JAMA’.
“These findings highlight the importance of continuous surveillance and efforts to prevent new cancers among survivors, says lead author Hyuna Sung. The number of cancer survivors developing new cancers is expected to increase, but so far, comprehensive data on the risk of PPS among survivors of adult-onset cancers have been limited. ”
For the study, the researchers analyzed data on nearly 1.54 million survivors cancer from 1992 to 2017 from 12 surveillance, epidemiology, and end-result registries in the United States. The survivors analyzed were between 20 and 84 years old (with a mean age of 60.4 years).
The findings suggest that among the 1,537,101 survivors, 156,442 were diagnosed with CPC and 88,818 died from CPC. The results found that male survivors had an 11% higher risk of developing PCC and a 45% higher risk of dying from PCC compared to the risk in the general population. Surviving women had a 10% higher risk of developing CCP and a 33% higher risk of dying from it.
The researchers found that the men who survived laryngeal cancer and Hodgkin lymphoma they had the highest risk of developing PCC, while men who survived gallbladder cancer had the highest risk of dying from PCC. Among women, esophageal and laryngeal cancer survivors were at the highest risk of developing PCC.
There was substantial variation in the associations of specific types of early cancers with specific types of CCP risk. However, the study authors point to the prevalence of cancers related to smoking and obesity in the incidence and mortality of PCC.
The results show that Risks of CCP related to smoking were commonly elevated among survivors of early smoking-related cancers. Among all cancer survivors, four common smoking-related CCPs, including lung, urinary bladder, oral cavity / pharynx, and esophagus, accounted for between 26% and 45% of the total incidence and mortality of CCP. Furthermore, lung cancer only accounted for 31% to 33% of total mortality from CCP.
Similarly, survivors of many obesity-related cancers were at increased risk of developing obesity-related CPS. Among the survivors of all cancers, four common obesity-related cancers – colorectal, pancreas, corpus uteri, and liver – accounted for between 22% and 26% of total PCC mortality.
“These findings reinforce the importance of coordinated efforts by primary care physicians to mitigate CCP risks through attention to survival, with a greater focus on lifestyle factors, including smoking cessation, weight control, physical activity and healthy eating, such as receiving counseling or treatment (only for tobacco) to aid in the adoption of healthy habits, “adds Ahmedin Jemal, lead author of the paper.
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