Burn injury, gender and cancer risk: population-based cohort study using data from Scotland and Western Australia.
OBJECTIVE
To investigate the risk of cancer and potential gender effects in persons hospitalised with burn injury.


METHODS
Population-based retrospective cohort study using record-linkage systems in Scotland and Western Australia.


METHODS
Records of 37 890 and 23 450 persons admitted with a burn injury in Scotland and Western Australia, respectively, from 1983 to 2008. Deidentified extraction of all linked hospital morbidity records, mortality and cancer records were provided by the Information Service Division Scotland and the Western Australian Data Linkage Service.


METHODS
Total and gender-specific number of observed and expected cases of total ('all sites') and site-specific cancers and standardised incidence ratios (SIRs).


RESULTS
From 1983 to 2008, for female burn survivors, there was a greater number of observed versus expected notifications of total cancer with 1011 (SIR, 95% CI 1.3, 1.2 to 1.4) and 244 (SIR, 95% CI 1.12, 1.05 to 1.30), respectively, for Scotland and Western Australia. No statistically significant difference in total cancer risk was found for males. Significant excesses in observed cancers among burn survivors (combined gender) in Scotland and Western Australian were found for buccal cavity, liver, larynx and respiratory tract and for cancers of the female genital tract.


CONCLUSIONS
Results from the Scotland data confirmed the increased risk of total ('all sites') cancer previously observed among female burn survivors in Western Australia. The gender dimorphism observed in this study may be related to the role of gender in the immune response to burn injury. More research is required to understand the underlying mechanism(s) that may link burn injury with an increased risk of some cancers.
Burn Injury Research Unit, School of Surgery, University of Western Australia, Crawley, Western Australia, Australia.
Janine M
JM
Duke
Jacqui
J
Bauer
Mark W
MW
Fear
Suzanne
S
Rea
Fiona M
FM
Wood
James
J
Boyd
D000293:Adolescent; D000328:Adult; D000368:Aged; D002056:Burns / Q000150:complications*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000453:epidemiology* / Q000209:etiology*; D012189:Retrospective Studies; D018570:Risk Assessment; D012606:Scotland / Q000453:epidemiology; D017678:Sex Distribution; D012737:Sex Factors; D014904:Western Australia / Q000453:epidemiology; D055815:Young Adult
Epidemiology; Public Health