Patients With Prior Hematologic Malignancy at Increased Risk for Head and Neck Cancer, Study Finds

According to results from a recent retrospective study, patients previously diagnosed with a hematologic malignancy were found to be at a higher risk of developing head and neck cancers compared with patients without a prior hematologic malignancy.

According to the study, more than 1.3 million people in the United States have a hematologic malignant tumor at present or are in remission. While previous studies have shown that there is an increased risk of secondary neoplasms in patients with hematologic tumors, evidence specifically regarding the association between prior hematologic malignant tumors and head and neck cancer remains limited.

“Hematologic malignant tumors are among the most prevalent cancers in the United States. This large population of patients is unfortunately susceptible to future cancers. Studies of hematologic malignant tumors, such as chronic myelogenous leukemia, chronic lymphocytic leukemia, or small lymphocytic lymphoma, Hodgkin lymphoma, non-Hodgkin lymphoma, and multiple myeloma, have demonstrated long-term elevated risk [for] developing secondary neoplasms. In studies of patients who have undergone hematopoietic stem cell transplant… there is also a significantly elevated risk [for] second cancers,” wrote the study authors.

Researchers used the Veterans Affairs (VA) Corporate Data Warehouse to identify patients with prior diagnoses of hematologic malignant tumors and head and neck cancers born between January 1, 1910, and December 31, 1969. The trial evaluated data from 30,939,656 veterans (89.3% male; 10.7% female). Outpatient lists were then queried for diagnosis of hematologic malignancies and found 207,322 patients, 1353 of whom were later diagnosed with head and neck cancer.

Having a history of a hematologic malignancy was significantly associated with overall aerodigestive tract cancer, with a relative risk (RR) of 1.6 (95% CI, 1.5-1.7), as well as oral cavity (RR, 1.7; 95% CI, 1.5-1.9), oropharynx (RR, 1.7; 95% CI, 1.5-1.9), larynx (RR, 1.3; 95% CI, 1.2-1.5), nasopharynx (RR, 2.8; 95% CI, 2.1-3.9), sinonasal (RR, 3.0; 95% CI, 2.2-4.1), salivary gland (RR, 2.8; 95% CI, 2.4-3.3), and thyroid (RR, 2.1; 95% CI, 1.9-2.4) tumors on subsite analysis. Furthermore, a prior hematologic malignancy was negatively associated with 2- and 5- year overall survival for multiple subsites of cancer.

Overall, the researchers determined that a prior diagnosis of hematologic or associated malignant tumors was associated with an increased risk of solid head and neck cancers in a range of subsites. “These results indicate that a prior hematologic malignant tumor may be an adverse risk factor in the development and progression of head and neck cancer,” concluded the authors.

Reference

Mowery A, Conlin M, Clayburgh D. Risk of head and neck cancer in patients with prior hematologic malignant tumors [published online May 2, 2019]. JAMA Otolaryngol Head Neck Surg. doi:10.1001/jamaoto.2019.1012