Personal History of Cancer as a Risk Factor for Second Primary Lung Cancer: Implications for Lung Cancer Screening

Authors

Sara Nofal
Jiangong Niu
Paul Resong
Jeff Jin
Kelly W Merriman
Xiuning Le
Hormuzd Katki
John Heymach
Mara B Antonoff
Edwin Ostrin
Jia Wu
Jianjun Zhang
Iakovos Toumazis

Publication Date

3-1-2024

Journal

Cancer Medicine

Abstract

Background: Personal history of cancer is an independent risk factor for lung cancer but is omitted from existing lung cancer screening eligibility criteria. In this study, we assess the lung cancer risk among cancer survivors and discuss potential implications for screening.

Methods: This was a retrospective, secondary analysis of data from the Surveillance, Epidemiology and End Results (SEER) registry and the MD Anderson Cancer Center (MDACC). We estimated the standardized incidence ratios (SIRs) for lung cancer by site of first primary cancer using data from SEER. We assessed the lung cancer risk among head and neck cancer survivors from MDACC using cumulative incidence and compared the risk ratios (RR) by individuals' screening eligibility status.

Results: Other than first primary lung cancer (SIR: 5.10, 95% CI: 5.01-5.18), cancer survivors in SEER with personal history of head and neck cancer (SIR: 3.71, 95% CI: 3.63-3.80) had the highest risk of developing second primary lung cancer, followed by bladder (SIR: 1.86, 95% CI: 1.81-1.90) and esophageal cancers (SIR: 1.78, 95% CI: 1.61-1.96). Head and neck cancer survivors had higher risk to develop lung cancer compared to the National Lung Screening Trial's subjects, (781 vs. 572 per 100,000 person-years, respectively). Head and neck cancer survivors ineligible for lung cancer screening seen at MDACC had significantly higher lung cancer risk than head and neck cancer survivors from SEER (RR: 1.9, p < 0.001).

Conclusion: Personal history of cancer, primarily head and neck cancer, is an independent risk factor for lung cancer and may be considered as an eligibility criterion in future lung cancer screening recommendations.

Keywords

Humans, Early Detection of Cancer, Lung Neoplasms, Retrospective Studies, Neoplasms, Second Primary, Risk Factors, Esophageal Neoplasms, Lung, Second primary lung cancer, cancer survivor, head and neck cancer, lung cancer screening, personal history of cancer, risk assessment

DOI

10.1002/cam4.7069

PMID

38466021

PMCID

PMC10926882

PubMedCentral® Posted Date

3-11-2024

PubMedCentral® Full Text Version

Post-print

Published Open-Access

yes