Prior malignant neoplasms as a risk factor for the second cancer in a cohort of employees of enterprises of the nuclear industrial complex

Abstract

Purpose. Assessment of the persistence ofprevious malignancy as a risk factor for the detection of subsequent cancer in a cohort of nuclear workers. Material and methods. Retrospective cohort study with 60 years of follow-up on 22.373 workers of nuclear facility recruited from 1948 to 2008, with the use of data on individual external and internal dosimetry, and information about cancer incidence and mortality rate due to cancer neoplasma (CN). Results. In the studied cohort second and subsequent CN were diagnosed in 6,4% cases, out of them 92,4% were cases of second cancers, in other cases the number of CN was more than two. 8% of cases ofprimary multiple cancers were presented by non-melanoma skin cancers (NMSC). Mean age ofpersons with more than one diagnosis of cancer was 67 years. The relative risk of the detection of second CN (excepting NMSC) among persons with already diagnosed previous cancer was about 4 times higher in comparison in persons without diagnosis of solid cancer. Discussion. Detected solid tumors were proposed to be diagnosed in the order of their occurrence, but it cannot be excluded that in different latent periods of solid cancers of various localization this condition may fail to comply. The radiotherapy and the effect of dispanserization could play the essential role in the occurrence of second and subsequent cancers when the possibility of the detection of CN in a patient being under dispensary observation by oncologist is higher than in persons without dispensary observation. At the same time, the one possibility of carcinogenic effect of the first malignancy must not be excluded. Conclusions. Cancer risk among nuclear workers who have previous malignancy was 4 times higher in comparison with workers who had no previous diagnosis of cancer.

Keywords

malignant neoplasms / second cancer / metachronous cancer / previous malignancy / occupational exposure / carcinogenic risk

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