title: Non-melanoma skin cancer may be a marker of poor prognosis in patients with non-Hodgkin's lymphoma.
abstract: According to recent results, patients with non-melanoma skin cancers are at increased risk of developing non-Hodgkin's lymphoma (NHL). The prognostic significance of this association is unknown. Two cohorts of patients with a first diagnosis of non-melanoma skin cancer and a subsequent diagnosis of either NHL (n = 170) or colon cancer (n = 435) were established using national cancer registry data in Denmark. Two other cohorts of patients in whom NHL (n = 600) or colon cancer (n = 1,541) was the patients' first known malignancy served as comparison groups. Mortality rates were compared using Cox's regression analysis. Among patients younger than 80 years at NHL diagnosis, a history of non-melanoma skin cancer was associated with significantly increased mortality [relative risk (RR) = 1.54; 95% confidence interval: 1.19-1.99]. This association was present in both men (RR = 1.38; 1.02-1.86) and women (RR = 2.15; 1.31-3.54) and was similar after both major subtypes of non-melanoma skin cancer. Overall, antedating non-melanoma skin cancer had no prognostic significance for colon cancer patients (RR = 1.00; 0.84-1.18). Whatever the underlying mechanism, our observation has potential clinical implications. If substantiated in other settings, NHL patients with prior non-melanoma skin cancer may constitute a subgroup of lymphoma patients in need of particular therapeutic attention.
authors.affiliation: Department of Epidemiology Research, Danish Epidemiology Science Centre, Statens Serum Institut, Copenhagen, Denmark. hhj@ssi.dk
authors.forename: H
authors.initials: H
authors.lastname: Hjalgrim
authors.forename: M
authors.initials: M
authors.lastname: Frisch
authors.forename: H H
authors.initials: HH
authors.lastname: Storm
authors.forename: B
authors.initials: B
authors.lastname: Glimelius
authors.forename: J B
authors.initials: JB
authors.lastname: Pedersen
authors.forename: M
authors.initials: M
authors.lastname: Melbye
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002280:Basal Cell Carcinoma / Q000401:mortality / Q000473:pathology; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology; D015331:Cohort Studies; D003110:Colonic Neoplasms / Q000401:mortality; D016001:Confidence Intervals; D005260:Female; D006801:Humans; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000401:mortality; D008228:Lymphoma, Non-Hodgkin / Q000401:mortality* / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D016609:Neoplasms, Second Primary / Q000401:mortality* / Q000473:pathology*; D011237:Predictive Value of Tests; D011379:Prognosis; D012737:Sex Factors; D012878:Skin Neoplasms / Q000401:mortality* / Q000473:pathology*; D013997:Time Factors