Deprivation linked to higher second cancer risk among England breast cancer survivors | Cancer

Female breast cancer survivors living in the most deprived areas have a 35% higher risk of developing a second, unrelated cancer, compared to those in the most affluent areas, a study has found.

Breast cancer is the most commonly diagnosed cancer in the UK, with around 56,000 people told they have it each year. Improved diagnosis and treatment means five-year survival rates are now 86% in England.

People who survive breast cancer have a higher risk of developing a second (unrelated) primary cancer, but until now the exact risk was unclear.

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 a higher increased risk of developing 12 other primary cancers.

They had a double risk of developing cancer in the unaffected (contralateral) breast, an 87% higher risk of endometrial cancer, a 58% higher risk of myeloid leukemia, and a 25% higher risk of breast cancer. the ovary.

The study, published in Lancet Regional Health – Europe, found that the risk of a second primary cancer was higher in people living in lower socio-economic areas.

Compared to the richest and least affluent women, breast cancer survivors had a 166% higher risk of developing lung cancer, a 78% higher risk of stomach cancer, a higher risk 50% higher risk of bladder and esophageal cancer, 48% higher risk of head and neck cancer, and 43% higher risk of kidney cancer.

Overall, people from the most deprived areas had a 35% higher risk of having a second cancer other than breast.

This may be because risk factors such as smoking, obesity and alcohol consumption are more common among more disadvantaged groups. A 2023 study found that deprivation leads to 33,000 extra cases of cancer in the UK each year.

First author Isaac Allen, from the University of Cambridge’s Department of Public Health and Primary Care, said: “This is the largest ever study of second cancers after breast cancer and the first to show that women diagnosed with breast cancer in deprived areas are more likely to contract a second cancer. Many cancers are caused by deprivation, but further research is clearly needed to identify the specific factors behind higher risks and how best to reduce these inequalities.

In addition to data from more than 580,000 women, the authors examined the risk of a second primary cancer for more than 3,500 male breast cancer survivors diagnosed between 1995 and 2019 using the national data set from cancer registration.

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 had four times the risk of cancer of the thyroid, although the actual numbers of these cancers were small.

Responding to the findings, Professor Pat Price, leading oncologist and co-founder of the Catch Up With Cancer campaign, said: “This highlights another example of alarming inequalities within cancer, highlighting the urgent need of a plan dedicated to cancer. A person’s race or socioeconomic status should not determine the chances of developing or surviving cancer.

Dr Simon Vincent, director of research, support and influence at Breast Cancer Now, said that although the higher risk of secondary cancer can occur due to genetic factors or the effects of initial breast cancer treatment, breast, more research is needed into the causes of second primary cancer. cancers and how to follow patients who complete primary treatment for breast cancer.