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Hodgkin’s lymphoma survivors at high risk of second cancers

Patients are 2.4 times more likely to develop secondary cancer.

Patients who are cured of Hodgkin’s lymphoma are at high risk of developing a second type of cancer, particularly if they have a family history of the disease, a major study has found

Hodgkin's lymphoma
Hodgkin’s lymphoma is a type of blood cancer – and one of the most common cancers
diagnosed in 13-24 year olds. Picture SPL

People who survived Hodgkin’s lymphoma are 2.4 times more likely to develop a second cancer of any type compared with those of the same age and sex in the general population, and this risk remained high 30 years after treatment, the study in the Journal of Clinical Oncology last month revealed. The risk was even greater in people who were treated for Hodgkin’s lymphoma and had a family history of those specific cancers.

Scientists found that patients treated for Hodgkin’s lymphoma were 3.5 times more likely to develop lung cancer if they had a close relative with the disease than those who did not. Those with a family history of breast or bowel cancer had around a twofold increased risk of developing that cancer themselves.

Treatment strategies

The study’s authors said the findings could help doctors identify patients most at risk of second cancers who might benefit from new risk-adapted treatment strategies, currently being evaluated in clinical trials, or increased monitoring for signs of specific second cancers.

Scientists at London’s Institute of Cancer Research, along with researchers in Sweden and Germany, analysed data from 9,522 patients with Hodgkin’s lymphoma and 28,277 relatives. Some 30% of people who had Hodgkin’s lymphoma in the study had one or more first-degree relatives with cancer. Those with a family history of cancer were 2.8 times more likely to get a second cancer compared with 2.2 times more likely for patients with no first-degree relatives with cancer. People with two or more first-degree relatives with cancer were 3.4 times more likely to develop a second cancer.

The most common second cancers were non-Hodgkin’s lymphoma, leukaemia and lung, breast, bowel and non-melanoma skin cancers.

Link to age

The researchers also found that increased risk of second cancer was linked to the age at diagnosis for both women and men. Women diagnosed with Hodgkin’s lymphoma under the age of 35 had a 14% risk of developing breast cancer over the next 30 years, whereas for those over 35 the risk was 3%.

Commenting on the study, Cancer Research UK’s head information nurse Martin Ledwick said: ‘People with Hodgkin’s lymphoma are at a greater risk of developing a second cancer, particularly in those who were treated with the radiotherapy approach that was used a few decades ago. A family history of breast cancer adds to their risk. This study is the first to show that a family history of lung and bowel cancer also play a role.

‘A family history of lung cancer carries the highest risk, and, as the risk hasn’t decreased as treatment has changed to use less radiotherapy, there may be factors other than heredity, such as family smoking habits, that are influencing the risk.’


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