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Radiation dose response for second primary cancers of the stomach, esophagus, and pancreas: a study of cancer survivors

Numerous studies have identified the bone marrow, thyroid gland and female premenopausal breast as the tissues most susceptible to ionization radiation in the human body. Less is known about the susceptibility of the organs of the gastrointestinal tract.

Project description


In 2003, the National Cancer Institute coordinated this study on radiation induced oesophagus, stomach and pancreas cancer. Patients with an initial breast-, testis-, cervix cancer and malignant lymphoma and subsequent oesophagus, stomach and pancreas cancer were selected and cohorts created. In a second phase, nested case-control studies are conducted. Cases consisting of individuals with one of the first primary cancers and a subsequent oesophagus, stomach or pancreas cancer. Controls being those with only diagnosed with any of the first cancers.
Detailed information on tumour characteristics and therapy has been gathered from the case records and the abstraction was finalized during the spring of 2007. In parallel, tissue has been collected from first and second cancers. Polymorphisms in mainly DNA repaired genes will be analyzed and related to risk of a second cancer.

A number of studies focusing on radiation-induced stomach, oesophagus and pancreas cancer have been completed. All of them were nested case-control studies and different groups have taken responsibility for different outcomes. A number of papers have been published as listed below.

Project leader for the Swedish part: Per Hall
Project period: 2002-2015
Main financing: National Cancer Institute (NCI)


Ruth Kleinerman, Dr., Radiation and Epidemiology Branch, National Cancer Institute, USA
Lindsay Morton, Dr., Radiation and Epidemiology Branch, National Cancer Institute, USA