Deprivation linked to a higher risk of second cancer among breast cancer survivors in England
Female breast cancer survivors living in the most deprived areas have a 35% higher risk of developing a second, unrelated cancer, compared to women from the most affluent areas. research shows.
Breast cancer is the most commonly diagnosed cancer in Britain; About 56,000 people are diagnosed with it every year. Improved diagnosis and treatments mean that the five-year survival rate is now 86% in England.
People who survive breast cancer are more likely to develop a second primary (unrelated) cancer, but until now the exact risk was not clear.
A team of researchers led by the University of Cambridge analyzed NHS data from almost 600,000 patients in England and found that compared to the general female population, women who had survived breast cancer had an increased risk of developing twelve other primary cancers .
They had double the risk of developing cancer in the unaffected (contralateral) breast, an 87% increased risk of endometrial cancer, a 58% increased risk of myeloid leukemia and a 25% increased risk of ovarian cancer.
The study, published in Lancet Regional Health – Europe, found that the risk of second primary cancers was higher in people living in areas of greater socio-economic disadvantage.
Compared to the most affluent, the least affluent female breast cancer survivors had a 166% increased risk of developing lung cancer, a 78% increased risk of stomach cancer, a more than 50% increased risk of bladder and esophageal cancer, and a 48% higher risk of head -neck cancer and 43% increased risk of kidney cancer.
Overall, those from the most deprived areas had a 35% higher risk of a second non-breast cancer.
This may be because risk factors such as smoking, obesity and alcohol use are more common among more disadvantaged groups. A 2023 study found that deprivation causes 33,000 extra cases of cancer in Britain every year.
The first author, Isaac Allen, from the Department of Public Health and Primary Care at the University of Cambridge, said: “This is the largest ever study to examine second cancers after breast cancer and the first to show that women diagnosed with breast cancer in underserved regions are more likely to develop second cancers. Many cancers are caused by deprivation, but more research is clearly needed to identify the specific factors driving the higher risks and how best to reduce these inequities.”
In addition to data from more than 580,000 women, the authors examined the risk of second primary cancers for more than 3,500 male breast cancer survivors diagnosed between 1995 and 2019 using the National Cancer Registry Dataset.
Male breast cancer survivors were 55 times more likely than the general male population to develop contralateral breast cancer, 58% more likely than the general male population to develop prostate cancer, and four times more likely to develop thyroid cancer, although the actual numbers of these cancer cases were low.
Commenting on the findings, Prof. Pat Price, a leading oncologist and co-founder of the Catching Up with Cancer Campaign, said: “This highlights another example of alarming cancer inequalities, underscoring the urgent need for a dedicated cancer plan. Where someone comes from or their socio-economic status should not determine their chances of developing or surviving cancer.”
Dr. Simon Vincent, director of research, support and advocacy at Breast Cancer Now, said that while the higher risk of secondary cancer may occur due to genetic factors or the effects of initial breast cancer treatment, more research is needed into the causes of second primary cancer. cancer and how to monitor patients completing primary breast cancer treatment.