Premium
Influence of family history on risk of second primary cancers and survival in patients with squamous cell skin cancer
Author(s) -
Chattopadhyay S.,
Zheng G.,
Hemminki A.,
Försti A.,
Sundquist K.,
Sundquist J.,
Hemminki K.
Publication year - 2020
Publication title -
british journal of dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.304
H-Index - 179
eISSN - 1365-2133
pISSN - 0007-0963
DOI - 10.1111/bjd.18809
Subject(s) - family history , medicine , proportional hazards model , hazard ratio , confidence interval , cancer , relative risk , risk factor , oncology
Summary Background Patients with squamous cell skin cancer ( SCC ) have an excellent prognosis but second primary cancers ( SPC s) weaken survival prospects. Family history is a known risk factor for cancer but whether it is a risk factor for SPC in patients with SCC is not known. Objectives To quantify the risk of family history on SPC s in patients with SCC and estimate survival probabilities of patients with SPC s depending on family history. Methods With 13 945 histologically verified SCC s, relative risks ( RR s) were estimated for family history using a generalized regression model. For survival analysis, hazard ratios ( HR s) were assessed using a multivariable Cox proportional‐hazards model. Results Family history of invasive SCC increased risk of second invasive SCC [ RR = 42·92, 95% confidence interval ( CI ) 33·69–50·32] compared with risk without family history ( RR 19·12, 95% CI 17·88–21·08). Family history of any nonskin cancer in invasive SCC increased risk of the same cancers to be diagnosed as SPC ( RRF H = 1·48, 95% CI 1·35–1·61 vs. RR no FH = 1·40, 95% CI 1·32–1·48); significant increases were observed for seven different nonskin cancers. Most results were replicated for in situ SCC . SPC was deleterious for survival irrespective of family history; HR for patients with SPC was 4·28 (95% CI 3·83–4·72) vs. those without SPC (1·04). Conclusions Family history of nonskin cancer was associated with approximately a doubling of risk for SPC s in patients with SCC . SPC increases the death rate in patients with SCC 3–4 times, irrespective of family history. Taking family history into account at SCC diagnosis may help prevention or early detection of SPC s.What's already known about this topic? Second primary cancers (SPCs) are frequently diagnosed in patients with invasive and in situ squamous cell carcinoma (SCC); some epidemiological studies suggest a link to immune dysfunction. Family history of cancer is a risk factor for practically all first primary cancers but whether it also influences risk of SPCs in patients with SCC is not known. The possible influence of family history on survival in patients with SCC remains to be established.Linked Comment: Youlden and Baade. Br J Dermatol 2020; 183 :414–415.