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Site-specific risk of second primary malignancy according to treatment of Hodgkin lymphoma

Site-specific risk of second primary malignancy according to treatment of Hodgkin lymphoma
Site Chemotherapy only Chemotherapy plus radiotherapy
# of patients SIR 95% CI AER # of patients SIR 95% CI AER
All malignancies, except nonmelanoma skin cancer and Hodgkin lymphoma* 157 2.0 1.7 to 2.4 32.9 302 3.9 3.5 to 4.4 65.3
Lung 40 2.9 2.0 to 3.9 10.7 60 5.1 3.8 to 6.5 14.0
Non-Hodgkin lymphoma 31 11.5 7.8 to 16.3 11.6 51 17.1 12.7 to 22.5 13.9
Leukemia, excluding CLL 33 26.7 18.4 to 37.5 13.0 42 30.6 22.1 to 41.4 11.8
Leukemia 33 18.4 12.7 to 25.9 12.8 42 22.7 16.3 to 30.7 11.7
Nonmelanoma skin cancer 6 0.5 0.2 to 1.0 –2.8 30 2.4 1.6 to 3.4 5.1Δ
Breast (female) 5 0.5 0.2 to 1.2 –1.8 30 2.4 1.6 to 3.4 5.1Δ
Unspecified primary 2 0.5 0.1 to 1.9 –0.7 16 4.7 2.7 to 7.6 3.7
Colon, rectum 10 1.1 0.5 to 1.9 0.2 17 2.0◊ 1.2 to 3.2 2.4
Esophagus 1 0.5 0.01 to 2.9 –0.4 7 4.1§ 1.6 to 8.4 1.5
Stomach 4 1.1 0.3 to 2.9 0.2 8 2.7◊ 1.2 to 5.3 1.5
Soft tissue 0 0 0 to 7.9 –0.2 5 8.9 2.9 to 20.7 1.3
Melanoma 1 0.5 0.01 to 2.8 –0.4 7 2.7◊ 1.1 to 5.5 1.3
Tongue, mouth, pharynx 2 1.3 0.2 to 4.6 0.2 6 3.5◊ 1.3 to 7.7 1.2
Nervous system 3 1.2 0.2 to 3.5 0.2 7 2.3 0.9 to 4.8 1.2
Cervix 2 1.4 0.2 to 4.9 0.2 6 2.7 1.0 to 5.8 1.1
Pancreas 2 1.0 0.1 to 3.7 0.0 5 2.9 0.9 to 6.7 0.9
Small intestine 0 0 0 to 20.1 –0.1 3 16.2§ 3.3 to 47.3 0.8
Thyroid 1 2.3 0.1 to 12.9 0.2 3 5.1◊ 1.1 to 15.0 0.7
Prostate 4 0.7 0.2 to 1.9 –0.6 6 1.5 0.5 to 3.2 0.6
Bone 0 0 0 to 20.7 –0.1 2 9.0◊ 1.1 to 32.5 0.5
Liver 2 3.4 0.4 to 12.5 0.6 2 3.7 0.4 to 13.3 0.4
Pleura 3 6.3◊ 1.3 to 18.5 1.0 2 4.4 0.5 to 15.9 0.4
Corpus uteri 0 0 0 to 3.1 –0.5 2 1.5 0.2 to 5.5 0.2
Testis 2 1.7 0.2 to 6.2 0.3 1 0.6 0.01 to 3.3 –0.2
Second primary malignancies identified in a cohort of 3564 men and 2234 women treated for Hodgkin lymphoma in Britain from 1963 to 2001.
AER: absolute excess risk per 10,000 person-years; CLL: chronic lymphocytic leukemia; SIR: standardized incidence ratio.
* In addition to specified sites, one laryngeal, one gallbladder, two ovarian, two bladder, and two kidney cancers occurred in chemotherapy-only patients, and one laryngeal, one heart, one adrenal, two ovarian, two bladder, and three kidney cancers and one myeloma and three cancers of ill-defined site occurred in mixed-modality patients.
¶ p<0.001.
Δ By coincidence, results for nonmelanoma skin cancer and for breast (female) cancer after chemotherapy plus radiotherapy are the same with one digit after the decimal point. This is not a typographical error.
◊ p<0.05.
§ p<0.01.
From: Swerdlow AJ, Higgins CD, Smith P, et al. Second Cancer Risk After Chemotherapy for Hodgkin's Lymphoma: A Collaborative British Cohort Study. J Clin Oncol 2011; 29(31):4096-4104. Reprinted with permission. Copyright © 2011 American Society of Clinical Oncology. All rights reserved.
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