| Abstrakt: |
The increased risk of subsequent primary malignancies ( SPM) in survivors of adult-onset Hodgkin lymphoma ( HL) and non-Hodgkin lymphoma ( NHL) remains a challenging clinical problem worldwide. The German cancer registry database, pooled from 14 federal states, was used to calculate the standardized incidence ratio ( SIR) and excess absolute risk ( EAR) of SPM in 128 587 patients registered with first primary HL/ NHL between 1990 and 2012. Conversely, SIRs were also calculated for a subsequent HL/ NHL following other first cancers. The risk of developing SPM was significantly increased over twofold for HL survivors ( SIR = 2·14, EAR = 51·87 cases/10 000 person-years) and 1·5-fold for NHL survivors ( SIR = 1·48, EAR = 55·23) compared with the general German population. For solid cancers, SIRs were significantly elevated (1·6- and 1·4-fold; respectively) and were highest (threefold) in patients below 30 years of age upon initial diagnosis. Overall, SIRs were consistently elevated for lip/oral cavity, colon/rectum, lung, skin melanoma, breast, kidney and thyroid. Significantly increased SIRs for oesophagus, stomach, liver, pancreas, testis, prostate, and brain/central nervous system were observed following NHL only. For certain SPM, SIRs remained significantly elevated more than 10 years following HL/ NHL diagnosis. Positive reciprocal associations were demonstrated between HL/ NHL and several solid cancers mentioned above; for some, common aetiological mechanisms seem plausible. [ABSTRACT FROM AUTHOR] |
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