Subsequent Primary Malignancies in Patients with Nonmelanoma Skin Cancer in England: A National Record-Linkage Study

Ong, Eugene Liat Hui; Goldacre, Raph; Hoang, Uy; Sinclair, Rodney; Goldacre, Michael J

doi:10.1158/1055-9965.epi-13-0902

Cited by 32 publications

(45 citation statements)

References 33 publications

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“…Others have also found higher risks of subsequent cancer after NMSC in younger age groups. [13], [21] Studies of Kaiser Permanente patients reported estimates of relative risk closer to ours, based on 822 patients with in situ or invasive SCC (HR 1.4; 95% CI 1.2, 1.6) [8], and on 3164 patients with BCC (HR 1.2; 95% CI 1.1, 1.4) [9]. Chen studied 165 individuals with SCC, 513 with BCC, 60 with both and 31 with unknown subtype from the volunteer-based CLUE II cohort.…”

Section: Discussionmentioning

confidence: 99%

Non Melanoma Skin Cancer and Subsequent Cancer Risk

Rees

Zens²,

Gui³

et al. 2014

PLoS ONE

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IntroductionSeveral studies have shown an increased risk of cancer after non melanoma skin cancers (NMSC) but the individual risk factors underlying this risk have not been elucidated, especially in relation to sun exposure and skin sensitivity to sunlight.PurposeThe aim of this study was to examine the individual risk factors associated with the development of subsequent cancers after non melanoma skin cancer.MethodsParticipants in the population-based New Hampshire Skin Cancer Study provided detailed risk factor data, and subsequent cancers were identified via linkage with the state cancer registry. Deaths were identified via state and national death records. A Cox proportional hazard model was used to estimate risk of subsequent malignancies in NMSC patients versus controls and to assess the potential confounding effects of multiple risk factors on this risk.ResultsAmong 3584 participants, risk of a subsequent cancer (other than NMSC) was higher after basal cell carcinoma (BCC) (adjusted HR 1.40 [95% CI 1.15, 1.71]) than squamous cell carcinoma (SCC) (adjusted HR 1.18 [95% CI 0.95, 1.46]) compared to controls (adjusted for age, sex and current cigarette smoking). After SCC, risk was higher among those diagnosed before age 60 (HR 1.96 [95% CI 1.24, 3.12]). An over 3-fold risk of melanoma after SCC (HR 3.62; 95% CI 1.85, 7.11) and BCC (HR 3.28; 95% CI 1.66, 6.51) was observed, even after further adjustment for sun exposure-related factors and family history of skin cancer. In men, prostate cancer incidence was higher after BCC compared to controls (HR 1.64; 95% CI 1.10, 2.46).ConclusionsOur population-based study indicates an increased cancer risk after NMSC that cannot be fully explained by known cancer risk factors.

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Section: Discussionmentioning

confidence: 99%

Non Melanoma Skin Cancer and Subsequent Cancer Risk

Rees

Zens²,

Gui³

et al. 2014

PLoS ONE

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“…Although KC has a low mortality rate of 1/100,000 [1,2], several previous studies have suggested a positive association between the history of KC and the risk of subsequent second primary cancers (SPCs) in other organs [6–10]. A meta-analysis reported that KC was associated with about a 10% increased risk of SPCs [7].…”

Section: Introductionmentioning

confidence: 99%

Risk of second primary cancer associated with pre-diagnostic smoking, alcohol, and obesity in women with keratinocyte carcinoma

Park

et al. 2017

Cancer Epidemiology

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Keratinocyte carcinoma (KC), which includes basal-cell carcinoma (BCC) and squamous-cell cancer (SCC), has been associated with an increased risk of second primary cancers (SPCs), although the reason for this increase is unknown. We assessed the effects of smoking, alcohol, and obesity prior to the diagnosis of KC on the development of SPCs, as these are well-established risk factors for multiple cancers and may also contribute to the increased risk of SPCs among those with KC. A total of 15,628 women with self-reported KC were identified in the Nurses’ Health Study. Incident SPCs were assessed throughout the follow-up until June 2012. Cox proportional hazards models were used to calculate the hazard ratios (HRs) of SPC associated with pre-diagnostic smoking, alcohol and body mass index (BMI). We also compared these risk estimates to those for first cancers in all cohort participants. During 193,695 person-years of follow-up, we recorded 2839 SPC cases. Compared with never smokers, current smokers had a significantly elevated risk for SPC overall and specifically for lung, colorectal, and bladder cancers. We also found a positive association between higher BMI and risk for SPC overall as well as for endometrial and bladder SPCs. Women with KC who consumed alcohol ≥30 g/day had a marginally higher risk of SPC compared to non-drinkers. The associations between incident SPC risk among KC cases and smoking, alcohol, and obesity appeared similar to the associations between these risk factors and the incident first primary cancers in the whole cohort. Only in the heavy smoking (≥25 cigarettes/day) category was the HR for SPC after KC (2.34; 95% CI 1.98–2.76) slightly higher than that for the first cancer in the overall cohort (HR 1.86; 95% CI 1.75–1.98, Pheterogeneity = 0.01). In conclusion, pre-diagnostic smoking, alcohol and obesity prior to KC diagnosis were associated with risk of SPCs.

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“…1–3 Inherited predisposition may be a contributory factor 4 as this association is stronger in those with early age-of-onset KC. 1, 2 A positive family cancer history is associated with increased cancer risk. 5 However, skin cancer is usually ignored when investigating family cancer history.…”

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confidence: 99%