The following is a summary of “Predictors of Secondary Lung Cancer Among Hodgkin Lymphoma Survivors: A Nationwide Analysis” published in the December 2022 issue of Clinical Lung Cancer by Alnimer et al.
Hodgkin lymphoma (HL) survivors may be at increased risk for developing lung cancer, but there is a lack of information on the frequency with which this occurs or the risk factors that may put them at greater risk. Researchers used the Surveillance, Epidemiology, and End Results (SEER) database to examine the records of patients diagnosed with HL between 1973 and 2015. Information such as age, gender, year of HL diagnosis, Ann-Arbor stage, histology, race, date of the last follow-up, date of death, and treatment modalities were gathered.
From the 56,856 HL patients identified, 862 were diagnosed with secondary lung cancer, with an incidence rate of 157 (95% CI: 147-168) per 100,000 person-years. People who developed lung cancer as a secondary complication of HL had a shorter median overall survival from the time of their HL diagnosis (12.1 years, 95% CI: 10.7-13) compared to those who did not acquire lung cancer (27.1 years, 95% CI: 26.5-27.6) (log-rank P-value <.01). After adjustment for confounding factors by propensity score, there was still an increased risk of subsequent lung cancer among those who received radiation therapy (hazard ratio [HR] 1.23, 95% CI [95% CI 1.002-1.55; P=0.048]. Furthermore, the odds of developing HL increased by a factor of 1.07 (95% CI: 1.062-1.073) for each year older than the patient was when the diagnosis was made and by a factor of 1.602 (95% CI: 1.33-1.94 for males). In addition, the risk was exclusively elevated in those of advanced age who underwent chemotherapy.
Within 9.1 years of an HL diagnosis, 50% of patients will get secondary lung cancer. This is especially true for those who were older, male, or who received radiation therapy or chemotherapy.