Dr. Weeks’ Comment: Rather than first doing no harm (primum non nocere) – many treatments cause more harm than benefit.
Radiation therapy for cervical cancer increases risk for colorectal cancer
The UTMB researchers, finding a high incidence of secondary colorectal cancers among cervical cancer survivors treated with radiation, offer new recommendations that the younger women in this group begin colorectal cancer screening about eight years after their initial cervical cancer diagnosis instead of waiting until age 50. The study is now online in the journal Medical Oncology.
An estimated 18 percent of malignancies in the United States are secondary cancers that develop in cancer survivors. Previous studies have indicated that cervical cancer survivors treated with radiation have an increased risk for second primary malignancies, yet no preventive recommendations have been established.
The UTMB study analyzed 64,507 cervical cancer cases collected from 1973-2009 by the National Cancer Institute Surveillance, Epidemiology and End Results program. Among cervical cancer survivors studied, colon, rectum and anus tumors were found to be two to four times more frequent in the group treated with radiation than in the group not treated with radiation. A breakdown of the findings include:
- More than half (52.6 percent) the cervical cancer patients studied received radiation treatment. Colon cancer among those treated with radiation began appearing at significantly higher rates approximately eight years later.
- After eight years, the risk for developing colon cancer was double for women who received radiation compared to those who had not.
- Their risk of rectal cancer quadrupled after 15 years.
- After 35 years, women who had received cervical cancer radiation therapy were three to four times more likely to have developed colorectal cancers than women who had not.
“We are confident from our study that it is time to consider new colorectal cancer screening strategies for cervical cancer survivors,” said UTMB’s Dr. Ana M. Rodriguez, assistant professor of obstetrics and gynecology and lead author of the study.
“As more people are surviving their cancer diagnosis, we need to learn more about the outcomes 10, 20, 30, even 40 years later and how to take care of their long-term medical needs.”
- Ana M. Rodriguez, Yong-Fang Kuo, James S. Goodwin. Risk of colorectal cancer among long-term cervical cancer survivors. Medical Oncology, 2014; 31 (5) DOI: 10.1007/s12032-014-0943-2