Prior Hematologic Malignant Tumors Tied to Increased Risk for Head and Neck Cancers

A prior diagnosis of hematologic malignant tumors is associated with an increased risk for head and neck cancers, according to a study published in JAMA Otolaryngology-Head & Neck Surgery (2019 May 2. Epub ahead of print).

“Previous studies have demonstrated an increased risk of secondary neoplasms in patients with hematologic malignant tumors, but research specifically on the risk of head and neck solid tumors in patients with prior hematologic malignant tumors is limited,” explained Alia Mowery, BS, School of Medicine, Oregon Health and Science University, Portland, and colleagues, who sought to examine this association and assess overall survival (OS) among these patients.

A total of 30,939,656 patients born between January 1, 1910, and December 31, 1969, with diagnoses of hematologic malignant tumors and head and neck cancers were identified using the Veterans Affairs Corporate Data Warehouse. Data analysis was performed between August 15, 2018, and January 31, 2019.

Diagnoses of hematologic malignant tumors and associated malignant tumors were determined using ICD-9 and ICD-10 codes of outpatient problem lists, and cancers were grouped by subsite. OS was determined from date of death or last outpatient visit.

A total of 207,322 had a hematologic malignant tumor; 1353 of them were later diagnosed with head and neck cancer. Prior diagnosis 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.

Furthermore, Ms Mowery and colleagues noted that prior diagnosis of hematologic malignant tumors was also negatively associated with 2- and 5-year OS for multiple subsites.

“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,” Ms Mowery and colleagues concluded.

“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,” they added.—Janelle Bradley