Risk Factor For Other Cancers Research Articles

Impact of thyroid cancer on the cancer risk in patients with non-alcoholic fatty liver disease or dyslipidemia

The raised prevalence of obesity has increased the incidence of obesity-related metabolic diseases such as dyslipidemia (DL) and non-alcoholic fatty liver disease (NAFLD), along with the development and progression of various types of cancer, including thyroid cancer. In this study, we investigated whether thyroid cancer in patients with DL and NAFLD could be a risk factor for other cancers. To achieve our goal, we generated two independent cohorts from our institution and from the National Health Insurance System in South Korea. Based on the ICD-10 code, we conducted exact matching (1:5 matching) and estimated the overall risk of thyroid cancer for other cancers in patients with DL or NAFLD. Univariate and multivariate analyses showed that the hazard ratio (HR) of thyroid cancer was 2.007 (95% Confidence Interval [CI], 1.597–2.522) and 2.092 (95% CI, 1.546–2.829), respectively in the institutional cohort and 1.329 (95% CI, 1.153–1.533) and 1.301 (95% CI, 1.115–1.517), respectively in the nationwide cohort. Risk analysis revealed a significant increase in the HR in lip, tongue, mouth, lung, bone, joint, soft tissue, skin, brain, male cancers and lymphoma after thyroid cancer occurred. Thyroid cancer in patients with DL or NAFLD might be a valuable factor for predicting the development of other cancers.

Associação prevalência e fatores de risco entre obesidade e câncer de mama

No Brasil e no mundo a um aumento dos índice de câncer de mama a cada ano, logo os indivíduos obesos possuem um risco de 1,5 a 3,5 mais chances de desenvolver um câncer e a obesidade também é fator de risco para outros canceres. O presente artigo tem por objetivo analisar a associação, prevalência e fatores de risco entre obesidade e câncer de mama. Trata-se de uma revisão integrativa da literatura realizada através dos bancos de dados da Biblioteca Virtual de Saúde (BVS), Scientific Electronic Library Online (SCIELO) e Literatura Latino-Americana e do Caribe em Ciências em Saúde (LILACS). Após a seleção de vinte artigos, apenas sete fizeram parte da amostra final. De acordo com os resultados obtidos, na associação entre câncer de mama e obesidade, constatou-se na maioria dos estudos que estes estão diretamente interligados, os quais apresentam pré-obesidade e obesidade geral entre as mulheres com câncer de mama. Tais resultados estão intimamente ligados a mulheres em tratamento na pós-menopausa. Em relação à prevalência, esta se encontra alta entre a população estudada, os fatores de risco apontam o sedentarismo, a baixa realização de atividades físicas e o baixo conhecimento acerca dos benefícios da mesma. O presente estudo limita-se a associação prevalência e fatores de risco entre obesidade e câncer de mama. Diante do exposto fica evidente a importância de estudos como estes, desde que contribuem diretamente para os estudiosos da área, bem como para a literatura.

Relationship between sun safety behaviours and modifiable lifestyle cancer risk factors and vitamin D levels.

Sun exposure is the most importantenvironmental risk factor for causing skin cancer. This study examines the relationship between sun protection behaviours and modifiable lifestyle risk factors for other cancers as well as vitamin D levels. Cross-sectional data were analysed from two large national health surveys (n=31, 445 and n=5604). Sun exposure and protection were characterized by the presence of sunburn, duration of sun exposure, frequency of seeking shade, frequency of wearing a hat and frequency of wearing sunscreen. Using Statistical Analysis System (SAS) software 9.3.1, multivariate logistic regression models were compiled. Unhealthy behaviour practices were associated with sunburns or infrequent sun protection behaviour, such as cigarette consumption (either current or former smokers), second-hand smoke exposure, not having a regular doctor, higher level of alcohol consumption, street drug usage and low levels of fruit/vegetable consumption. Approximately one-quarter of individuals had less than the recommended value of serum vitamin D levels (<50nmol/L), despite 39.2% of these individuals reporting ≥1hour of sun exposure. Modifiable lifestyle risk factors for other cancers are correlated with infrequently practicing sun protection behaviours for skin cancer prevention. Therefore, cancer prevention campaigns can aim to target all these risk factors associated with different cancers. Sun exposure is not a reliable source to obtain recommended vitamin D levels and that other sources (eg. fish, egg yolk, fortified drinks and supplements) are a safer and more reliable option.

Opium and bladder cancer: A systematic review and meta-analysis of the odds ratios for opium use and the risk of bladder cancer.

ObjectiveThe association between opium use and bladder cancer has been investigated in many studies, with varying reporting results reported. This study aims to estimate the total odds ratio for the association between bladder cancer and opium consumption using meta-analysis.MethodsThe study was designed according to PRISMA guidelines. Two independent researchers searched for the relevant studies using PubMed, Web of Science, Scopus, OVID, Embase, and Google Scholar. After systematic screening of the studies identified during the first step, Cochrane risk of bias tool was determined for the selected studies. The case-control and the cohort studies were investigated to assess risk of bladder cancer due to opium use. In addition, the cross-sectional studies were analysed separately to assess frequency of opium consumption. These estimates were combined using the inverse variance method. Fixed or random effect models were applied to combine the point odds ratios. The heterogeneity between the primary results was assessed using the Cochran test and I-square index. The suspected factors for heterogeneity were investigated using meta-regression models. An Egger test was conducted to identify any probable publication bias. Forest plots illustrated the point and pooled estimates. All analyses were performed using Stata version 14 software and RevMan version 5.3.ResultsWe included 17 primary studies (11 case-control, one cohort and five cross-sectional) in the final meta-analysis. The total odds ratios (95% confidence intervals) for developing bladder cancer by opium use alone, and concurrent use of opium and cigarettes were estimated as 3.85 (3.05–4.87) and 5.7 (1.9–16.3) respectively. The odds ratio (95% confidence interval) for opium use with or without cigarette smoking was estimated as 5.3 (3.6–7.7).ConclusionThis meta-analysis showed that opium use similar to cigarette smoking and maybe with similar mechanisms can be a risk factor for bladder cancer. It is therefore expected to be a risk factor for other cancers.

The impact of body mass index and height on the risk for glioblastoma and other glioma subgroups: a large prospective cohort study.

Glioma comprises a heterogeneous group of mostly malignant brain tumors, whereof glioblastoma (GBM) represents the largest and most lethal subgroup. Body height and body mass index (BMI) are risk factors for other cancers, but no previous study has examined anthropometric data in relation to different glioma subgroups. This prospective cohort study includes 1.8 million Norwegian women and men between ages 14 and 80 years at baseline. Body weight and height were measured, and incident cases of glioma were identified by linkage to the National Cancer Registry. Cox regression analyses were performed to evaluate risk for different glioma subgroups in relation to anthropometric measures. During 54 million person-years of follow-up, 4,382 gliomas were identified. Overweight and obesity were not associated with risk for any glioma subgroup. Height was positively associated with risk for GBM and all other gliomas (hazard ratio [HR] per 10 cm increase: 1.24; 95% confidence interval [CI], 1.17-1.31 and 1.18; 95% CI, 1.09-1.29) but not with the proxy for isocitrate dehydrogenase (IDH)-mutant glioma (HR, 1.09; 95% CI, 0.98-1.21). In further subgroup analyses, the effect of height on glioma risk varied significantly with positive associations for oligoastrocytoma (HR, 1.74; 95% CI, 1.20-2.53) and malignant glioma not otherwise specified (NOS) (HR, 1.42; 95% CI, 1.16-1.76, but not with diffuse astrocytoma (WHO grades II and III) or oligodendroglioma. This epidemiologic study consolidates height as a risk factor for GBM and other gliomas. It further indicates that this association is not universal for gliomas but may differ between different glioma subgroups.

Incidence and prognostic impact of other cancers in a population of long-term survivors of chronic lymphocytic leukemia

Information on the impact of other cancers (OCs) in long-term survivors (LTSs) of chronic lymphocytic leukemia (CLL) is limited. Patients with CLL who survived >10 years were defined as LTSs of CLL. We calculated standardized incidence ratios (SIRs) to compare the incidence of OC in LTS of CLL versus the general population. A multivariable model was used to identify independent predictors of OC. Overall survival was analyzed as a function of the presence of OC. Among 797 LTSs of CLL, the cumulative frequency of OC was 36%, similar between 570 patients (72%) who required treatment for CLL (TRT) and 227 (28%) who remained untreated (UT). The most common OC in both groups was non-melanoma skin cancer, followed by prostate cancer, breast cancer, melanoma, lung cancer, and leukemia in TRT patients, and by prostate cancer, breast cancer, melanoma, lung cancer, and gastrointestinal tumors in the UT group. The SIR for all OC was 1.2 (P = 0.034). It was higher in males (SIR 1.31; P = 0.013) and patients <60 years (SIR 1.27; P = 0.027). A higher SIR was shown for secondary leukemia, melanoma, and head-and-neck cancers, whereas a lower SIR was found for gastrointestinal and bladder cancers. Independent predictors of OC development were advanced age, male gender, and lower platelets. The survival of patients with OC was 16.2 months and that of patients without OC 22.9 years. LTSs of CLL have an increased incidence of OC compared with the general population. CLL therapy is not a risk factor for OC in LTSs of CLL. The presence of an OC in these patients may be associated with shorter survival.

Dietary Factors and the Risk of Thyroid Cancer: A Review

In the past few decades, the incidence of thyroid cancer has rapidly increased worldwide. Thyroid cancer incidence is relatively high in regions where the population's daily iodine intake is insufficient. While low dietary iodine has been considered as a risk factor for thyroid cancer development, previous studies found controversial results across different food types. Among different ethnic groups, dietary factors are influenced by various dietary patterns, eating habits, life-styles, nutrition, and other environmental factors. This review reports the association between dietary factors and thyroid cancer risk among ethnic groups living in different geologic regions. Iodine-rich food such as fish and shellfish may provide a protective role in populations with insufficient daily iodine intake. The consumption of goitrogenic food, such as cruciferous vegetables, showed a positive association with risk. While considered to be a risk factor for other cancers, alcohol intake showed a protective role against thyroid cancer. High consumption of meat such as chicken, pork, and poultry showed a positive association with the risk, but dairy products showed no significant association. Regular use of multivitamins and dietary nitrate and nitrite also showed a positive association with thyroid cancer risk. However, the study results are inconsistent and investigations into the mechanism for how dietary factors change thyroid hormone levels and influence thyroid function are required.

Other Cancers in Patients With Chronic Lymphocytic Leukemia Requiring Therapy: Association With Prognostic Factors and Impact on Survival

Abstract 3896 Chronic lymphocytic leukemia (CLL) is associated with an increased incidence of other cancers (OC). Potential risk factors for OC in CLL include immune disturbances, shared risk factors, genetic predisposition and chemotherapy. While reports on OC in patients with CLL have been typically descriptive in nature, detailed information regarding the clinical features of OC, relationship with the time of diagnosis of CLL, patient characteristics, prognostic factors and survival have been missing. We report an analysis of OC in pts with CLL requiring therapy, with a post therapy observation time of 5 years or longer. We reviewed our database and selected pts with CLL seen at our center who underwent treatment and who have a follow-up of at least 5 years after therapy. We studied pts with an OC either before or after the diagnosis and/or treatment of CLL and compared them with patients without OC. Richter's transformation of CLL was not considered an OC in this analysis. A total of 1,364 pts with CLL referred between 1963 and 2007 with a median follow up time of 8.2 years (range 5–28) were studied. Among these, we identified 324 pts (24%) with OC. Sixty-eight pts were diagnosed with >1 OC [2 OC (62 pts), 3 OC (4 pts) or 4 OC (2 pts)], for a total of 400 individual OC. Of the 324 pts with OC, OC preceded the diagnosis of CLL in 117 pts (36%), with a median time from OC to CLL of 80 (0–455) months, OC occurred after the diagnosis of CLL but before treatment in 49 pts (15%), with median time from CLL to OC of 22 (0–131) months. OC occurred after treatment of CLL in 158 pts (49%), with a median time from treatment to OC of 94 (0–304) months. The type, frequency and timing of OC are summarized in [table 1][1]. Clinical characteristics and traditional prognostic factors were not significantly different between pts with and without OC, with the exception of age, as pts with OC are older than pts without OC at the time of referral (median age: 60 vs 55 years, p 5 years, the incidence of OC is 24%. Among pts with OC, there is a trend for higher number of pts with del11q. In pts with OC, OC itself is a major cause of death, while the vast majority of deaths among pts without OC are caused by CLL or CLL-related complications. | Site of OC | 1st case | Total cases | OC prior/at CLL | OC after CLL | |:---------------------------------------:| --------------- | ----------- | --------------- | ------------ | --- | | After diagnosis | After treatment | | NMSC[1][2] | 124 | 144 | 41 | 26 | 77 | | PROSTATE | 43 | 54 | 18 | 7 | 29 | | MELANOMA | 26 | 34 | 16 | 2 | 16 | | BREAST | 23 | 26 | 14 | 2 | 10 | | MDS/AML[2][3] | 16 | 18 | | | 18 | | LUNG | 14 | 21 | | 1 | 20 | | NEUROENDOCRINE | 3 | 6 | 1 | | 5 | | HEAD AND NECK | 12 | 16 | 3 | 2 | 11 | | UROTHELIAL CELL CANCERS | 11 | 12 | 7 | 2 | 3 | | GI[3][4] (including pancreas and liver) | 10 | 18 | 4 | 3 | 11 | | KIDNEY | 10 | 11 | 4 | 3 | 4 | | NHL[4][5] and MM[5][6] | 8 | 12 | | | 12 | | TESTIS/OVARY | 6 | 6 | 4 | | 2 | | THYROID | 6 | 7 | 5 | 1 | 1 | | SARCOMAS | 4 | 5 | 4 | | 1 | | UTERUS | 2 | 3 | 3 | | | | OTHERS[6][7] | 6 | 7 | 3 | | 4 | | TOTALS | 324 | 400 | 127 | 49 | 224 | * [↵][8]1 non-melanoma skin cancers; * [↵][9]2 myelodysplastic syndrome/acute myeloid leukemia; * [↵][10]3 gastrointestinal; * [↵][11]4 non-Hodgkin's lymphoma; * [↵][12]5 multiple myeloma; * [↵][13]6 includes: brain, nasopharyngeal, penis carcinoma, mesothelioma, unknown primary. Table 1. Distribution of OC (1364 pts). Disclosures: No relevant conflicts of interest to declare. [1]: #T1 [2]: #fn-1 [3]: #fn-2 [4]: #fn-3 [5]: #fn-4 [6]: #fn-5 [7]: #fn-6 [8]: #xref-fn-1-1 [9]: #xref-fn-2-1 [10]: #xref-fn-3-1 [11]: #xref-fn-4-1 [12]: #xref-fn-5-1 [13]: #xref-fn-6-1

Other Cancers in Patients with Chronic Lymphocytic Leukemia Requiring Therapy: Association with Prognostic Factors and Impact On Survival

AbstractAbstract 3896Chronic lymphocytic leukemia (CLL) is associated with an increased incidence of other cancers (OC). Potential risk factors for OC in CLL include immune disturbances, shared risk factors, genetic predisposition and chemotherapy. While reports on OC in patients with CLL have been typically descriptive in nature, detailed information regarding the clinical features of OC, relationship with the time of diagnosis of CLL, patient characteristics, prognostic factors and survival have been missing. We report an analysis of OC in pts with CLL requiring therapy, with a post therapy observation time of 5 years or longer. We reviewed our database and selected pts with CLL seen at our center who underwent treatment and who have a follow-up of at least 5 years after therapy. We studied pts with an OC either before or after the diagnosis and/or treatment of CLL and compared them with patients without OC. Richter’s transformation of CLL was not considered an OC in this analysis. A total of 1,364 pts with CLL referred between 1963 and 2007 with a median follow up time of 8.2 years (range 5–28) were studied. Among these, we identified 324 pts (24%) with OC. Sixty-eight pts were diagnosed with >1 OC [2 OC (62 pts), 3 OC (4 pts) or 4 OC (2 pts)], for a total of 400 individual OC. Of the 324 pts with OC, OC preceded the diagnosis of CLL in 117 pts (36%), with a median time from OC to CLL of 80 (0–455) months, OC occurred after the diagnosis of CLL but before treatment in 49 pts (15%), with median time from CLL to OC of 22 (0–131) months. OC occurred after treatment of CLL in 158 pts (49%), with a median time from treatment to OC of 94 (0–304) months. The type, frequency and timing of OC are summarized in table 1. Clinical characteristics and traditional prognostic factors were not significantly different between pts with and without OC, with the exception of age, as pts with OC are older than pts without OC at the time of referral (median age: 60 vs 55 years, p<.0001). We next analyzed the distribution of the newer prognostic parameters in these two groups. Fifty-three % of pts with OC had unmutated IGHV genes, 65% were ZAP70+, 22% CD38+, 8% had del17p, 27% del11q, 22% +12, 20% negative FISH, and 23% del13q. Sixty-one % of pts without OC had unmutated IGHV genes, 58% were ZAP70+, 26% CD38+, 6% had del17p, 17% del11q, 22% +12, 26% negative FISH, and 29% del13q. A trend toward significance (p.07) for a higher incidence of del11q was observed in pts with OC. At the time of this analysis 536 (39%) pts have died and 828 (61%) are alive. One hundred seventy six/324 (54%) pts with OC are alive, vs 652/1040 (63%) pts without OC (p<.007). Median overall survival (OS) has not been reached in either pt group at a median follow up of 95 (61–284) months for pts with OC and 98 (61–340) months for pts without OC. Causes of death were: progression of CLL (99), CLL-related complications (121), OC (43), complications of stem cell transplant (16), events unrelated to CLL (39) and unknown causes (218). In pts with OC, the OC itself was the cause of death in 37%. Other causes of death were CLL/CLL-related complications in 44%, complications of stem cell transplant in 8%, and events unrelated to CLL in 11%. In contrast, in pts without OC CLL/CLL-related complications accounted for 83% of deaths, complications of stem cell transplant for 4%, and events unrelated to CLL for 13%. In conclusion, in pts with CLL requiring therapy and with post therapy follow up of >5 years, the incidence of OC is 24%. Among pts with OC, there is a trend for higher number of pts with del11q. In pts with OC, OC itself is a major cause of death, while the vast majority of deaths among pts without OC are caused by CLL or CLL-related complications.Table 1Distribution of OC (1364 pts).Site of OC1st caseTotal casesOC prior/at CLLOC after CLLAfter diagnosisAfter treatmentNMSC1124144412677PROSTATE435418729MELANOMA263416216BREAST232614210MDS/AML216180018LUNG14210120NEUROENDOCRINE36105HEAD AND NECK12163211UROTHELIAL CELL CANCERS1112723GI3 (including pancreas and liver)10184311KIDNEY1011434NHL4 and MM58120012TESTIS/OVARY66402THYROID67511SARCOMAS45401UTERUS23300OTHERS667304TOTALS324400127492241non-melanoma skin cancers;2myelodysplastic syndrome/acute myeloid leukemia;3gastrointestinal;4non-Hodgkin's lymphoma;5multiple myeloma;6includes: brain, nasopharyngeal, penis carcinoma, mesothelioma, unknown primary. Disclosures:No relevant conflicts of interest to declare.

Nonmelanoma Skin Cancer and the Risk of Second Primary Cancers: a Systematic Review

Based on empirical evidence, a personal history of nonmelanoma skin cancer (NMSC) has been hypothesized to be a risk factor for other cancers. Others hypothesize that NMSC may be a marker of high cutaneous vitamin D synthesis and therefore inversely associated with risk of other malignancies. To reconcile these divergent views, we carried out a systematic review to determine the association between NMSC and subsequent risk of other cancers. Bibliographic databases were searched through March 2009. Studies were included if sufficient information was presented to estimate the risk of developing other cancers following NMSC. Studies were reviewed and data were abstracted independently in duplicate with disagreements resolved by consensus. Of the 21 included studies, 15 reported the association between NMSC and risk of all other cancers combined. NMSC was significantly associated with increased risk of another malignancy among cohort studies based on cancer registries summary random-effects relative risk (SRR), 1.12; 95% confidence interval (CI), 1.07-1.17; n = 12 studies) and those with individual-level data (SRR, 1.49; 95% CI, 1.12-1.98; n = 3). In stratified analyses of registry studies, this association held true for both squamous (SRR, 1.17; 95% CI, 1.12-1.23; n = 7) and basal cell carcinoma (SRR, 1.09; 95% CI, 1.01-1.17; n = 7), and both men (SRR, 1.14; 95% CI, 1.09-1.20; n = 12) and women (SRR, 1.10; 95% CI, 1.04-1.15; n = 12). Strong, consistent evidence indicates that a personal history of NMSC is associated with increased risk of developing other malignancies. For unknown reasons, NMSC may be a risk factor for other cancers.

Commentary on “European Consensus Statement on Lung Cancer”

Commentary on “European Consensus Statement on Lung Cancer”