Massey researchers lead multi-decade analysis of new cancer incidence among survivors

By Massey Comprehensive Cancer Center staff

As people continue to live longer and the survival rate of cancer diagnoses increases, researchers from VCU Massey Comprehensive Cancer Center led a multi-decade analysis studying the rates of subsequent primary cancers, also known as SPCs, which are new cancers unrelated to the original diagnosis. The study, which was recently published in PLOS Medicine, provides understanding for how these cancer risks change over time and across generations, helping guide future prevention and monitoring measures.

A team of Massey researchers used cancer registry data from over 3 million cancer survivors in the United States from 1975-2021 to study patterns of new cancer incidence, examining age, calendar period and birth cohort effects on SPC risk. Cancer survivorship is up 34% since 1991.

"Cancer survivors are surviving longer, and that gives them a higher chance of developing a subsequent primary cancer, but literature in that area is limited," said Hui Cheng, Ph.D., a member of Massey's Cancer Prevention and Survivorship Outcomes Research Lab and the article's primary author.

Researchers found that SPC risks varied by cancer type, sex and generation. In recent decades, SPC risks have declined among cancer survivors, with notable exceptions in female lung cancer and male bladder cancer survivors. Additionally, survivors diagnosed at older ages continued to face persistent or rising risks. In fact, the risk of developing a subsequent primary cancer increased in those who were older when first diagnosed, though breast cancer survivors showed stable risks across ages.

Overall, these findings highlight the importance of long-term monitoring of cancer survivors, as risks of SPCs remain substantial. Additionally, these findings can inform prevention strategies, survivorship care and public health planning.

"This is an opportunity to really evaluate your risk factors, your lifestyle and really become a survivorship warrior," said Oxana Palesh, Ph.D., Massey Cancer Center Chair in Cancer Research, co-leader of Massey's Cancer Prevention and Control research program and co-author of the study. "It is important to remind people that they have a lot of control over their individual cancer risk and prevention."

Massey's cancer survivorship program is unique in that it provides a holistic approach that focuses on a patient's cancer predispositions to guide personalized medical and treatment strategies while providing resources related to stress reduction, nutrition, sleep improvement and other lifestyle factors that can influence cancer risk.

"Whether it be our work in germline genetic testing, stress reduction or general lifestyle improvements, our program is incredibly impactful," said Susan Hong, M.D., director of the cancer survivorship program at Massey and co-author of the study.

Massey's survivorship program is actively engaged in research to improve patient care and outcomes and to inform how cancer care will be delivered across cancer centers in the U.S. One example of Massey's impact across the country is its three-year grant from the McKesson Foundation to examine how food access affects cancer patients receiving active treatment.

"Our program is one of the few that has an embedded food-as-medicine program," Hong said. "Plenty of cancer centers have food pantries, per se, but ours is one of the few that targets every single person in the cancer center who reports food insecurity because we have studies that demonstrate that cancer patients with food insecurity have higher rates of mortality, anxiety and depression, and are less likely to complete treatment."

Next, researchers will seek a supplemental grant to collect data from outside the clinic, specifically allowing for home monitoring of patients to increase the amount of data available to researchers.

This story was originally published on the Massey Comprehensive Cancer Center website.