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@ARTICLE{Zheng:163648,
      author       = {G. Zheng$^*$ and K. Sundquist and J. Sundquist and A.
                      Försti$^*$ and A. Hemminki and K. Hemminki$^*$},
      title        = {{R}ate differences between first and second primary cancers
                      may outline immune dysfunction as a key risk factor.},
      journal      = {Cancer medicine},
      volume       = {9},
      number       = {21},
      issn         = {2045-7634},
      address      = {Hoboken, NJ},
      publisher    = {Wiley},
      reportid     = {DKFZ-2020-01926},
      pages        = {8258-8265},
      year         = {2020},
      note         = {#EA:C050#LA:C050#LA:C020# / 2020 Nov;9(21):8258-8265},
      abstract     = {Many cancers are increased in immunosuppressed patients and
                      evidence is accumulating that immune dysfunction may be a
                      contributing risk factor for second primary cancers (SPCs).
                      The aim of this study was to explore the potential influence
                      of immune mechanisms in SPC.We used the Swedish Cancer
                      Registry (1990-2015) to select 13 male and 14 female first
                      primary cancers (FPCs) that are known to be related to
                      immune suppression. We assessed relative risks (RRs) for any
                      of these as concordant (same first and second cancer) and
                      discordant FPC-SPC pairs. Hierarchical clustering of
                      significant RRs was performed for cancers as FPC and
                      SPC.Concordant risks for SPCs were excessive in men and
                      women for nasal (RRs 59.3 for men and 150.6 for women),
                      tongue/mouth (51.7 and 100.8), and lip (32.4 and 61.2)
                      cancers. Heatmaps showed that some cancers, such as skin
                      cancer, tongue/mouth cancers, and non-Hodgkin lymphoma had
                      multiple bidirectional associations as FPC and SPC. Nasal
                      cancer and chronic lymphocytic leukemia had associations
                      mainly as FPC while liver and kidney cancers showed most
                      associations as SPC.Immune dysfunction may be a plausible
                      contributing factor for most of the associations, which
                      calls for experimental verification.},
      cin          = {C050 / B062 / HD01 / C020},
      ddc          = {610},
      cid          = {I:(DE-He78)C050-20160331 / I:(DE-He78)B062-20160331 /
                      I:(DE-He78)HD01-20160331 / I:(DE-He78)C020-20160331},
      pnm          = {313 - Cancer risk factors and prevention (POF3-313)},
      pid          = {G:(DE-HGF)POF3-313},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:32960498},
      doi          = {10.1002/cam4.3454},
      url          = {https://inrepo02.dkfz.de/record/163648},
}