20 Mar Short Telomere Length, Cancer Survival, and Cancer Risk in 47102 Individuals
MedicalResearch.com Interview with Stig E. Bojesen
Staff specialist, MD, PhD, DMSci
Dept. of Clinical Biochemistry, Copenhagen University Hospital
Herlev Hospital DK-2730 Herlev Denmark
MedicalResearch.com: What are the main findings of the study?
Dr. Bojesen: The most interesting findings were the increased risk of early death after cancer by decreasing telomere length – measured even before the cancer disease surfaced in the individual. This association was present even after adjusting for all known markers of adverse prognosis. We did not expect this, but it has important implications for how we might apply this marker in the management of cancer patients.
The second – and also important and unexpected finding – was the overall lack of association with risk of cancer, after adjustment for the most common ordinary risk factors like age, gender, smoking and so on. This was in contrast to former meta-analyses and many other smaller studies suggesting increased cancer risk with decreasing telomere length. We could reject this hypothesis with considerable statistical power.
MedicalResearch.com: What should clinicians and patients take away from your report?
Dr. Bojesen: There are two important messages for concrete clinical situations.
The first is that a measurement of the telomere length in your white blood cells, is not able to tell you more about your future overall cancer risk, than a combination of your age, gender, smoking habits and so on.
The second and equally important message is that telomere length in leukocytes might be able to help us identifying the cancer patients either with a particular good and particular bad prognosis, independently of the classical prognostic factors in cancer. This, however, will need considerable amount of work before it can be used clinically.
MedicalResearch.com What recommendations do you have for future research as a result of this study?
Dr. Bojesen: Telomere length remains an important potential biomarker since it reflects very fundamental biological mechanisms.
The next steps should be to explore why telomere length is an independent marker of adverse prognosis in cancer patients, and to identify subgroups where measurement of telomere length could be of particular value for the clinicians.
As a part of this, it would of very interesting to perform sequential measurements of telomere length in the same patient during the chemotherapy regimens, in order to identify factors with particular effect on telomere length and consequently on risk of early death.
Short Telomere Length, Cancer Survival, and Cancer Risk in 47102 Individuals.
Weischer M, Nordestgaard BG, Cawthon RM, Freiberg JJ,
Tybjærg-Hansen A, Bojesen SE.
Affiliations of authors: Department of Clinical Biochemistry (MW, BGN, JJF, SEB) and The Copenhagen General Population Study (MW, BGN, JJF, AT-H, SEB) , Herlev Hospital, Copenhagen University Hospital, Herlev, Denmark; Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark (MW, BGN, AT-H, SEB); The Copenhagen City Heart Study, Frederiksberg Hospital, Copenhagen University Hospital, Copenhagen, Denmark (BGN, AT-H, SEB); Department of Human Genetics, University of Utah, Salt Lake City, UT (RMC); Department of Clinical Biochemistry, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark (AT-H).
J Natl Cancer Inst. 2013 Mar 6. [Epub ahead of print]