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Burn injury, gender and cancer risk: population-based cohort study using data from Scotland and Western Australia
  1. Janine M Duke1,
  2. Jacqui Bauer2,
  3. Mark W Fear1,
  4. Suzanne Rea1,3,
  5. Fiona M Wood1,3,4,
  6. James Boyd2
  1. 1Burn Injury Research Unit, School of Surgery, University of Western Australia, Crawley, Western Australia, Australia
  2. 2Population Health Research Network, Centre for Data Linkage, Curtin University, Perth, Western Australia, Australia
  3. 3Burns Service of Western Australia, Royal Perth Hospital and Princess Margaret Hospital, Perth, Western Australia, Australia
  4. 4Fiona Wood Foundation, Crawley, Western Australia, Australia
  1. Correspondence to Professor Janine M Duke; janine.duke{at}uwa.edu.au

Abstract

Objective To investigate the risk of cancer and potential gender effects in persons hospitalised with burn injury.

Design Population-based retrospective cohort study using record-linkage systems in Scotland and Western Australia.

Participants Records of 37 890 and 23 450 persons admitted with a burn injury in Scotland and Western Australia, respectively, from 1983 to 2008. Deidentified extraction of all linked hospital morbidity records, mortality and cancer records were provided by the Information Service Division Scotland and the Western Australian Data Linkage Service.

Main outcome measures Total and gender-specific number of observed and expected cases of total (‘all sites’) and site-specific cancers and standardised incidence ratios (SIRs).

Results From 1983 to 2008, for female burn survivors, there was a greater number of observed versus expected notifications of total cancer with 1011 (SIR, 95% CI 1.3, 1.2 to 1.4) and 244 (SIR, 95% CI 1.12, 1.05 to 1.30), respectively, for Scotland and Western Australia. No statistically significant difference in total cancer risk was found for males. Significant excesses in observed cancers among burn survivors (combined gender) in Scotland and Western Australian were found for buccal cavity, liver, larynx and respiratory tract and for cancers of the female genital tract.

Conclusions Results from the Scotland data confirmed the increased risk of total (‘all sites’) cancer previously observed among female burn survivors in Western Australia. The gender dimorphism observed in this study may be related to the role of gender in the immune response to burn injury. More research is required to understand the underlying mechanism(s) that may link burn injury with an increased risk of some cancers.

  • Epidemiology
  • Public Health

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 3.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/3.0/

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