Molecular epidemiology of secondary lung cancer

The aim of this project was to examine the risk of lung cancer in women with breast cancer taking ionizing radiation and tobacco use into consideration.

Project description


An increasing number of women are diagnosed with breast cancer and at the same time mortality is decreasing. This means that the prevalence of cancer survivors is increasing and that late adverse health effects caused by ionizing radiation and chemotherapy is becoming an increasing problem. It has for some 30 years been known that women with breast cancer are more likely to develop a subsequent lung cancer. If this is due to an effect of ionizing radiation, tobacco, or an interaction between the two of them, has not been examined in detail.


During 2007 we finalized abstraction of information from case records. We abstracted information on tumour characteristics and therapy and copied treatment charts enabling calculation of lung doses. This was performed by Dr. Giovanna Gagliardi at the Department of Oncology, Karolinska University Hospital.
At the same time we collected tumour blocks from cases and controls. The cases were defined as those diagnosed with both breast and lung cancer and the controls were those diagnosed with breast cancer only. Analyses of p53 mutation spectra, DNA, repaired genes, and epigenetics was performed by Prof. Peter Shields at Georgetown University, Washington. In parallel, we gathered information on tobacco use from case records and next-of-kin.

Project leader for the Swedish 


Per Hall

Organizational unit: Department of Medical Epidemiology and Biostatistics (MEB), C8

Project period: 2000-2011
Main financing: National Institutes of Health (NIH)


Name Role
Peter Shields Professor, Georgetown University, USA
Giovanna Gagliardi Dr., Karolinska University Hospital


Ionizing radiation and tobacco use increases the risk of a subsequent lung carcinoma in women with breast cancer: case-only design.
Prochazka M, Hall P, Gagliardi G, Granath F, Nilsson B, Shields P, et al
J. Clin. Oncol. 2005 Oct;23(30):7467-74

Lung cancer