History of Cancer

This website is for informational purposes only and not a substitute for medical advice.

Summary

  • A personal history of cancer is linked to higher long-term risk of dying from any cause, partly due to second cancers, treatment late effects (especially heart disease), and other long-term changes after cancer.
  • The extra risk can last for decades, especially in people treated for cancer in childhood, adolescence, or young adulthood (AYA).
  • Family history mainly increases your chance of getting certain cancers; for some cancer types it is also linked to higher cancer-related death, which can raise all-cause mortality.
  • Many risks are modifiable: long-term follow-up care, prevention of cardiovascular disease, staying physically active, and mental health support are all linked to better survival in cancer survivors.

Factor description

  • This factor is based on self-report.
  • Personal cancer history means you have ever been diagnosed with cancer at any time in your life (past or current). This can include skin cancers.
  • Family cancer history means close biological relatives (for example, parents, siblings, children; sometimes extended relatives) have had cancer.
  • Measurement methods differ:
    • Self-report: yes/no/unknown answers about diagnoses in you and your family
    • Medical records/genetic testing: can confirm diagnoses and identify hereditary syndromes (for example, BRCA1/2, Lynch)

Impact on all-cause mortality

  1. Personal cancer history: why all-cause risk is higher

    • Second primary cancers: survivors can develop new, separate cancers later in life, increasing long-term mortality.
    • Treatment late effects: some therapies raise later risk of cardiovascular disease (heart attack, stroke, heart failure), which is a major driver of all-cause mortality.
    • Reduced physical function and accelerated aging signals: lower fitness and physical function are repeatedly linked to higher mortality in survivors.
    • Mental health and metabolic risks: depression/anxiety, diabetes, hypertension, smoking, and obesity can compound risk.

  2. What studies typically show (direction and size)

    • Cancer survivors generally have higher all-cause mortality than people without a cancer history, even though survival has improved over time.
    • The size of the difference varies strongly by:
      • cancer type
      • age at diagnosis (especially childhood/AYA vs later-life cancers)
      • treatment exposures (for example, chest radiation, anthracyclines)
      • time since diagnosis (risk often decreases over time but may remain elevated)
    • Examples from the provided evidence:
      • Childhood/AYA survivors: roughly 4–6× higher all-cause mortality than the general population, with excess risk lasting decades.
      • Breast cancer survivors: about 1.8× higher all-cause mortality than cancer-free women, with long-term elevation.
    • In some high-comorbidity settings (example: older adults on hemodialysis), active cancer is linked to much higher mortality, while a remote past cancer may not add measurable risk in that specific group.

  3. Family history: how it connects to all-cause mortality

    • Family history mainly acts by increasing cancer incidence (more people develop cancer), which can increase cancer deaths and therefore all-cause mortality.
    • The association differs by cancer site:
      • For some cancers (for example, lung, gastric, colorectal, melanoma), family history is linked to higher incidence and higher mortality.
      • For others (for example, breast and prostate), family history does not necessarily worsen survival after diagnosis and may sometimes be linked to earlier detection and better follow-up (which can improve outcomes).
    • Hereditary syndromes (for example, BRCA1/2, Lynch) can lead to earlier onset and higher lifetime risk; without prevention and surveillance, this can worsen long-term outcomes.

Patterns

  • Who is most affected

    • Childhood, adolescent, and young-adult (AYA) cancer survivors, especially those exposed to treatments that increase late cardiovascular risk.
    • Survivors with multiple risk factors: smoking, obesity, high blood pressure, diabetes, high LDL cholesterol, low fitness, or depression/anxiety.
    • People with strong family history (multiple relatives, early-onset cancers) or known hereditary syndromes.

  • Typical risk modifiers seen across studies

    • Cancer type and stage at diagnosis.
    • Time since diagnosis (risk often changes over years/decades).
    • Treatment exposures and cumulative doses.
    • Access to survivorship care and preventive healthcare.

  • Practical pattern for families

    • Clustering of certain cancers in families can reflect inherited variants, shared environments, or shared behaviors.
    • When family history is strong or cancers occur unusually early, genetic counseling is more likely to be useful.

KamaLama scoring

KamaLama scoring for this topic is event-based and additive:

  • Personal cancer history and family cancer history are scored as separate items.
  • Each item applies a fixed life-expectancy adjustment (in years), rather than a gradual dose-response curve.
  • If a user selects an “I don’t know” option and no score is defined, the score is marked as Not found (no guessing).
Category/RangeScore (in years)
cancer_history_yes-10.0
cancer_history_no0.0
cancer_family_history_yes-2.0
cancer_family_history_no0.0

Practical tips

  • If you have had cancer, ask your clinician for a survivorship care plan (screening schedule, late-effect monitoring, and who follows what).
  • Keep cardiovascular prevention simple and consistent: don’t smoke, walk regularly, and control blood pressure, LDL cholesterol, and blood sugar.
  • Build fitness and strength gradually (aerobic + resistance training); physical function is strongly linked to long-term survival in survivors.
  • If you had chest radiation or anthracycline chemotherapy, ask whether you need cardio-oncology follow-up or earlier heart screening.
  • If you have strong family history (multiple relatives, early-onset cancers, or specific patterns), consider genetic counseling and, if appropriate, panel testing.
  • Stay up to date on standard cancer screenings (colon, cervical, breast, skin) and adjust timing based on personal and family history.

References

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