Telomere Length and Risk of Incident Cancer and Cancer Mortality

Willeit, Peter; Willeit, Johann; Mayr, Agnes; Weger, Siegfried; Oberhollenzer, Friedrich; Brandstätter, Anita; Kronenberg, Florian; Kiechl, Stefan

doi:10.1001/jama.2010.897

Cited by 425 publications

(347 citation statements)

References 36 publications

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“…4 Together, these changes suggest an effect of the interventions on potentially important biomarkers of psychosocial stress. Given the increasingly well-documented association between TL and cancer initiation 46 and survival, 47 this finding adds to the literature supporting the potential for stress-reducing interventions to impact important disease-regulating processes and ultimately disease outcome. 48 Inconsistent with other findings, 23,28 we did not observe any associations between changes in stress or mood scores over the course of the interventions and concomitant changes in TL.…”

Section: Discussionmentioning

confidence: 75%

“…disease or survival outcomes, 13 whereas other studies have shown that TL was related to breast cancer risk 46,51 and survival. 10,46,47 Although interpretation remains difficult, the results of the current study nonetheless provide provocative new data that suggest it is possible to influence TL in cancer survivors through the use of psychosocial interventions involving group support, emotional expression, stress reduction, and mindfulness meditation. …”

mentioning

confidence: 98%

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Mindfulness‐based cancer recovery and supportive‐expressive therapy maintain telomere length relative to controls in distressed breast cancer survivors

Carlson

Beattie

Giese‐Davis

et al. 2014

Cancer

138

109

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BACKGROUND: Group psychosocial interventions including mindfulness-based cancer recovery (MBCR) and supportive-expressive group therapy (SET) can help breast cancer survivors decrease distress and influence cortisol levels. Although telomere length (TL) has been associated with breast cancer prognosis, the impact of these two interventions on TL has not been studied to date. METHODS: The objective of the current study was to compare the effects of MBCR and SET with a minimal intervention control condition (a 1-day stress management seminar) on TL in distressed breast cancer survivors in a randomized controlled trial. MBCR focused on training in mindfulness meditation and gentle Hatha yoga whereas SET focused on emotional expression and group support. The primary outcome measure was relative TL, the telomere/single-copy gene ratio, assessed before and after each intervention. Secondary outcomes were self-reported mood and stress symptoms. RESULTS: Eighty-eight distressed breast cancer survivors with a diagnosis of stage I to III cancer (using the American Joint Committee on Cancer (AJCC) TNM staging system) who had completed treatment at least 3 months prior participated. Using analyses of covariance on a per-protocol sample, there were no differences noted between the MBCR and SET groups with regard to the telomere/single-copy gene ratio, but a trend effect was observed between the combined intervention group and controls (F [1,84], 3.82; P 5 .054; h 2 5 .043); TL in the intervention group was maintained whereas it was found to decrease for control participants. There were no associations noted between changes in TL and changes in mood or stress scores over time. CONCLUSIONS: Psychosocial interventions providing stress reduction and emotional support resulted in trends toward TL maintenance in distressed breast cancer survivors, compared with decreases in usual care. Cancer 2015;121:476-84.

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Section: Discussionmentioning

confidence: 75%

mentioning

confidence: 98%

Mindfulness‐based cancer recovery and supportive‐expressive therapy maintain telomere length relative to controls in distressed breast cancer survivors

Carlson

Beattie

Giese‐Davis

et al. 2014

Cancer

138

109

View full text Add to dashboard Cite

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“…158 In the general population, genetic variations in telomere-biology genes, namely TERT 159 and RTEL1 , 160 have been associated with the development of several cancers, and short telomere length with cancer risk and mortality in large epidemiological studies. 161,162 Although no studies have investigated telomere length and cancer risk after allogeneic HCT, several studies suggest that it may be important. Telomere shortening in the transplanted hematopoietic cells appeared to accelerate post-transplant when compared with age-matched controls or matched donors (reviewed in 163 ).…”

Section: Non-transplant-related Risk Factorsmentioning

confidence: 99%

National Institutes of Health Hematopoietic Cell Transplantation Late Effects Initiative: The Subsequent Neoplasms Working Group Report

Morton

Saber

Baker

et al. 2017

Biology of Blood and Marrow Transplantation

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Subsequent neoplasms (SN) following hematopoietic cell transplantation (HCT) cause significant patient morbidity and mortality. Risks for specific SN types vary substantially, with particularly elevated risks for post-transplant lymphoproliferative disorders, myelodysplastic syndrome/acute myeloid leukemia, and squamous cell malignancies. This consensus document provides an overview of the current state of knowledge regarding SN after HCT and recommends priorities and approaches to overcome challenges and gaps in understanding. Numerous factors have been suggested to impact risk, including patient-related (e.g., age), primary disease-related (e.g., disease type, pre-HCT therapies), and HCT-related characteristics (e.g., type and intensity of conditioning regimen, stem cell source, development of graft-versus-host disease). However, gaps in understanding remain for each of these risk factors, particularly for patients receiving HCT in the current era due to substantial advances in clinical transplantation practices. Additionally, the influence of non-transplant-related risk factors (e.g., germline genetic susceptibility, oncogenic viruses, lifestyle factors) is poorly understood. Clarification of the magnitude of SN risks and identification of etiologic factors will require large-scale, long-term, systematic follow-up of HCT survivors with detailed clinical data. Most investigations of the mechanisms of SN pathogenesis after HCT have focused on immune drivers. Expansion of our understanding in this area will require interdisciplinary laboratory collaborations utilizing measures of immune function and availability of archival tissue from SN diagnoses. Consensus-based recommendations for optimal preventative, screening, and therapeutic approaches have been developed for certain SN after HCT, whereas for other SN, general population guidelines are recommended. Further evidence is needed to specifically tailor preventative, screening, and therapeutic guidelines for SN after HCT, particularly for unique patient populations. Accomplishment of this broad research agenda will require increased investment in systematic data collection with engagement from patients, clinicians, and interdisciplinary scientists in order to reduce the burden of SN in the rapidly growing population of HCT survivors.

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“…In the last years telomere length (TL) has been intensively studied in relation to risk and survival of various cancer types, including hematological ones. 5,26,37,38 In particular in a very recent study performed within the European prospective investigation on cancer (EPIC), Hosnijeh et al 39 have shown that longer telomeres are associated with increased risk of MM. In most epidemiological studies TL is measured in DNA from peripheral blood and used as a proxy for TL in other tissues.…”

mentioning

confidence: 99%

Risk of multiple myeloma is associated with polymorphisms within telomerase genes and telomere length

Campa

Martino

Várkonyi

et al. 2014

Intl Journal of Cancer

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Compelling biological and epidemiological evidences point to a key role of genetic variants of the TERT and TERC genes in cancer development. We analyzed the genetic variability of these two gene regions using samples of 2,267 multiple myeloma (MM) cases and 2,796 healthy controls. We found that a TERT variant, rs2242652, is associated with reduced MM susceptibility (OR = 0.81; 95% CI: 0.72–0.92; p = 0.001). In addition we measured the leukocyte telomere length (LTL) in a subgroup of 140 cases who were chemotherapy‐free at the time of blood donation and 468 controls, and found that MM patients had longer telomeres compared to controls (OR = 1.19; 95% CI: 0.63–2.24; ptrend = 0.01 comparing the quartile with the longest LTL versus the shortest LTL). Our data suggest the hypothesis of decreased disease risk by genetic variants that reduce the efficiency of the telomerase complex. This reduced efficiency leads to shorter telomere ends, which in turn may also be a marker of decreased MM risk.

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Telomere Length and Risk of Incident Cancer and Cancer Mortality

Abstract: In this study population, there was a statistically significant inverse relationship between telomere length and both cancer incidence and mortality.

Cited by 425 publications

References 36 publications

Mindfulness‐based cancer recovery and supportive‐expressive therapy maintain telomere length relative to controls in distressed breast cancer survivors

Mindfulness‐based cancer recovery and supportive‐expressive therapy maintain telomere length relative to controls in distressed breast cancer survivors

National Institutes of Health Hematopoietic Cell Transplantation Late Effects Initiative: The Subsequent Neoplasms Working Group Report

Risk of multiple myeloma is associated with polymorphisms within telomerase genes and telomere length

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