Certain Hematologic Malignancies Increase Head/Neck Tumors

by U.S. Medicine

June 26, 2019

PORTLAND, OR—With more than 1.3 million people in the United States having been diagnosed with a hematologic malignant tumor currently or in remission, previous research has suggested an increased risk of secondary neoplasms.

Yet, the report in JAMA Otolaryngoly said that, in patients with hematologic malignant tumors, research specifically on the risk of head and neck solid tumors in patients with prior hematologic malignant tumors has been limited.1

To remedy that, researchers from the Portland, OR, VA Health System and Oregon Health and Science University sought to examine a possible association between prior hematologic malignant tumors and risk of head and neck cancer and to assess the overall survival among these patients.

For the retrospective analysis, the study team used the VA Corporate Data Warehouse to identify patients with diagnoses of hematologic malignant tumors and head and neck cancers. All patients in the VA CDW with a birthdate between Jan. 1, 1910, and Dec. 31, 1969, were included, resulting in a cohort of nearly 31 million veterans. Data analysis was performed from Aug. 15, 2018, to Jan. 31, 2019.

Most, 89.3%, of the participants were male, with about 45.2% of them white. More than 207,000 of them had been diagnosed with a hematologic malignant tumor, and 1,353 of those later developed head and neck cancer. 

Results indicated that a history of hematologic malignant tumors 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. Researchers also emphasized that a prior hematologic malignant tumor was negatively associated with two- and five-year OS for multiple 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,” the study authors concluded.

1 Mowery A, Conlin M, Clayburgh D. Risk of Head and Neck Cancer in Patients With Prior Hematologic Malignant Tumors. JAMA Otolaryngoly Head Neck Surg. 2019 May 2.  doi: 10.1001/jamaoto.2019.1012. [Epub ahead of print] PubMed PMID: 31045226.

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