KEP: Cancer Epidemiology

We aim to improve the understanding of determinants of risk and prognosis of cancer, with a special focus on malignant lymphomas and cancers arising after organ transplantation, as well as to characterize issues of cancer survivorship. The overall goal is to provide a better basis for primary prevention of cancer, prediction of risk and prognosis, and cancer rehabilitation.

Cancerepidemiology

Our research is based on linkages of large national health care registers enriched with clinical data from national cancer quality registers as well as a large bi-national case-control study of malignant lymphomas (the SCALE study). We collaborate with other research groups at KEP, other units at the Karolinska Institutet (CCK, MEB, IMM), researchers at other Swedish Universities (Uppsala, Lund), as well as internationally within the Nordic countries (the Nordic expert group on post-transplant malignancies) and within the InterLymph consortium.

 

Recent publications

Hodgkin Lymphoma

Hodgkin lymphoma affects young adults and is today a curable disease with intensive chemotherapy. In this recent article, published in Journal of Clinical Oncology, we have investigated the childbearing potential in survivors after Hodgkin lymphoma. We show that in the absence of relapse, contemporarily treated women have an improved childbearing potential with calendar time and women treated today give birth to the same degree as matched comparators.

Contemporarily Treated Patients With Hodgkin Lymphoma Have Childbearing Potential in Line With Matched Comparators.
Weibull C, Johansson A, Eloranta S, Smedby K, Björkholm M, Lambert P, et al
J. Clin. Oncol. 2018 Sep;36(26):2718-2725

Diffuse Large B-cell Lymphoma

Comorbidity impacts overall survival among patients with diffuse large B-cell lymphoma (DLBCL). However, associations of comorbidity with lymphoma characteristics, treatment selection and lymphoma-specific mortality are less well known. In this recent article, published in Journal of Internal Medicine, we have examined the impact of comorbidity on DLBCL characteristics, treatment intent and cause of death. We demonstrate that comorbidity is associated with inferior DLBCL outcome, mainly due to a lower likelihood of receiving treatment with curative intent. Among patients treated with curative intent, comorbidity only increased the risk of other-cause death, resulting in inferior overall but not lymphoma-specific survival. This demonstrates a need for effective treatments with a more tolerable toxicity profile for comorbid patients in particular, and optimization of comorbid conditions in parallel with DLBCL treatment.

Stacked cumulative probability of lymphoma-specific and other-cause death (stratified according to sex, age at diagnosis and level of comorbidities) among DLBCL patients treated with curative intent (n = 2799).

Impact of comorbidity on disease characteristics, treatment intent and outcome in diffuse large B-cell lymphoma: a Swedish lymphoma register study.
Wästerlid T, Mohammadi M, Smedby K, Glimelius I, Jerkeman M, Bottai M, et al
J. Intern. Med. 2018 Oct;():

Diffuse Large B-cell Lymphoma

Survival has improved among patients with diffuse large B-cell lymphoma (DLBCL) with the addition of anti-CD20 antibody therapy. In this article, published in the Americal Journal of Hematology, we illustrate recent gains and remaining unmet needs in DLBCL by measuring changes in loss in expectation of life over time. Despite improvements following the introduction of rituximab, continued large losses of life among young high-risk patients with primary refractory disease and early relapse as the most important challenges of current DLBCL practice. 

 

Long-term survival and loss in expectancy of life in a population-based cohort of 7114 patients with diffuse large B-cell lymphoma.
Ekberg S, Jerkeman M, Andersson P, Enblad G, Wahlin B, Hasselblom S, et al
Am. J. Hematol. 2018 May;():

Group members

 

Fredrik BaecklundAssociated

fredrik.baecklund@ki.se

Henrik BenoniGraduate Student

henrik.benoni@ki.se

Elsa BrånvallPhD student, Graduate Student

elsa.branvall@ki.se

Sara EkbergGraduate Student, Statistician

sara.ekberg@ki.se

Karin Ekström SmedbySenior researcher

Karin.Ekstrom.Smedby@ki.se

08-517 791 12

Sandra ElorantaResearch coordinator

sandra.eloranta@ki.se

Gabriella FriskGraduate Student

gabriella.frisk@ki.se

Ingrid GlimeliusAssociated

ingrid.glimelius@ki.se

Sara HarryssonGraduate Student

sara.harrysson@ki.se

David JarajAssociated

david.jaraj@ki.se

Joel JoelssonAssociated

joel.joelsson@ki.se

Andreas PetterssonAssociated

Andreas.H.Pettersson@ki.se

Tove WästerlidAssociated

tove.wasterlid@ki.se

Renata ZelicGraduate Student, Research assistant

renata.zelic@ki.se