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When Does Spleen Size Signal Cancer Risk?
TOPLINE:
Spleen volume larger than the 99th percentile was associated with an 11-fold increased risk for hematologic cancer compared with normal volumes, with 5-year risks as high as 46% among men aged 70 years or older. Significant risks for cirrhosis and liver cancer were also seen.
METHODOLOGY:
- Splenomegaly is often detected incidentally during imaging, but guidelines vary as to the threshold that should prompt evaluation — ranging from a spleen length of 120 mm to 150 mm. However, up to 21% of healthy individuals have spleen lengths > 120 mm, which could lead to unnecessary follow-up of low-risk patients.
- Researchers used data from two general population cohorts to evaluate the relative and absolute risks for hematologic cancer and liver disease (two common causes of spleen enlargement) among individuals with incidentally detected splenomegaly. They included 8459 Danish adults (57% female; median age, 61 years) and 38,607 UK adults (51.9% female; median age, 65 years) who underwent CT or MRI scans as part of study procedures.
- Spleen length and volume measurements were available from the Danish cohort, while only spleen volume was available from the UK group.
- Participants were followed for a median of 5 years after imaging to assess the incidence of hematologic cancers (both cohorts) and cirrhosis and liver cancer (UK cohort only). Hazard ratios were adjusted for age, sex, smoking status, alcohol consumption, comorbidities, and C-reactive protein levels.
TAKEAWAY:
- In the Danish cohort, the relative risk for any hematologic cancer was significantly increased among individuals with spleen lengths above the 99th percentile (≥ 135 mm) compared with those with spleen lengths in the 26th-74th percentile (hazard ratio [HR], 5.11; P < .001). Among individuals with a spleen length ≥ 140 mm, absolute 5-year risks reached 23% for men aged 70 years or older and 12% for women in that age group.
- Risks were even more pronounced for Danish adults with a spleen volume above the 99th percentile — > 433 mL. Relative to the 26th-74th percentile, their risk for any hematologic cancer was 11-fold higher (HR, 11.08; P < .001). Among people with a spleen volume ≥ 500 mL, 5-year risks reached 46% for men aged 70 years or older and 27% for women in that age group.
- Findings were similar in the UK cohort. Among individuals with a spleen volume above the 99th percentile (> 386 mL), the risk for hematologic cancer increased nearly 12-fold (HR, 11.82; P < .001). With a spleen volume ≥ 500 mL, 5-year risks reached 21% for men aged 70 years or older and 18% for women in that age group. Relative risks were also elevated — by 1.55-2.94 — among individuals in the 75th-99th percentile (199 mL-386 mL).
- The risks for liver disease began to rise substantially at a spleen volume ≥ 400 mL. Absolute 5-year risks for cirrhosis reached 10.8% for men and 9.3% for women aged 70 years or older with a spleen volume ≥ 500 mL. For liver cancer, 5-year risks reached 3.2% and 1.2% for men and women in that age group with a spleen volume ≥ 400 mL.
IN PRACTICE:
“To our knowledge, no previous studies have examined risk of hematologic cancers by spleen length or volume in incidentally detected splenomegaly,” the authors of the study wrote. “Risk was moderately increased at spleen length of 130-139 mm or spleen volume of 400-499 mL, where diagnostic workup may be considered, and more pronounced at spleen length of 140 mm or greater or spleen volume of 500 mL or greater, supporting that diagnostic workup may likely be relevant.”
They stressed, however, that the study participants were asymptomatic, and the underlying reason for imaging should always be considered.
SOURCE:
The study, led by Jens Helby, MD, PhD, Copenhagen University Hospital – Rigshospitalet, Copenhagen, Denmark, was published online in JAMA Oncology.
DISCLOSURES:
The study was funded by the Danish Cancer Society, the Boserup Foundation, Copenhagen University Hospital – Rigshospitalet, and Sanofi A/S. Helby reported having financial relationships with Sanofi and Disc Medicine. Additional disclosures are available in the full article.
This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.
A version of this article first appeared on Medscape.com.
TOPLINE:
Spleen volume larger than the 99th percentile was associated with an 11-fold increased risk for hematologic cancer compared with normal volumes, with 5-year risks as high as 46% among men aged 70 years or older. Significant risks for cirrhosis and liver cancer were also seen.
METHODOLOGY:
- Splenomegaly is often detected incidentally during imaging, but guidelines vary as to the threshold that should prompt evaluation — ranging from a spleen length of 120 mm to 150 mm. However, up to 21% of healthy individuals have spleen lengths > 120 mm, which could lead to unnecessary follow-up of low-risk patients.
- Researchers used data from two general population cohorts to evaluate the relative and absolute risks for hematologic cancer and liver disease (two common causes of spleen enlargement) among individuals with incidentally detected splenomegaly. They included 8459 Danish adults (57% female; median age, 61 years) and 38,607 UK adults (51.9% female; median age, 65 years) who underwent CT or MRI scans as part of study procedures.
- Spleen length and volume measurements were available from the Danish cohort, while only spleen volume was available from the UK group.
- Participants were followed for a median of 5 years after imaging to assess the incidence of hematologic cancers (both cohorts) and cirrhosis and liver cancer (UK cohort only). Hazard ratios were adjusted for age, sex, smoking status, alcohol consumption, comorbidities, and C-reactive protein levels.
TAKEAWAY:
- In the Danish cohort, the relative risk for any hematologic cancer was significantly increased among individuals with spleen lengths above the 99th percentile (≥ 135 mm) compared with those with spleen lengths in the 26th-74th percentile (hazard ratio [HR], 5.11; P < .001). Among individuals with a spleen length ≥ 140 mm, absolute 5-year risks reached 23% for men aged 70 years or older and 12% for women in that age group.
- Risks were even more pronounced for Danish adults with a spleen volume above the 99th percentile — > 433 mL. Relative to the 26th-74th percentile, their risk for any hematologic cancer was 11-fold higher (HR, 11.08; P < .001). Among people with a spleen volume ≥ 500 mL, 5-year risks reached 46% for men aged 70 years or older and 27% for women in that age group.
- Findings were similar in the UK cohort. Among individuals with a spleen volume above the 99th percentile (> 386 mL), the risk for hematologic cancer increased nearly 12-fold (HR, 11.82; P < .001). With a spleen volume ≥ 500 mL, 5-year risks reached 21% for men aged 70 years or older and 18% for women in that age group. Relative risks were also elevated — by 1.55-2.94 — among individuals in the 75th-99th percentile (199 mL-386 mL).
- The risks for liver disease began to rise substantially at a spleen volume ≥ 400 mL. Absolute 5-year risks for cirrhosis reached 10.8% for men and 9.3% for women aged 70 years or older with a spleen volume ≥ 500 mL. For liver cancer, 5-year risks reached 3.2% and 1.2% for men and women in that age group with a spleen volume ≥ 400 mL.
IN PRACTICE:
“To our knowledge, no previous studies have examined risk of hematologic cancers by spleen length or volume in incidentally detected splenomegaly,” the authors of the study wrote. “Risk was moderately increased at spleen length of 130-139 mm or spleen volume of 400-499 mL, where diagnostic workup may be considered, and more pronounced at spleen length of 140 mm or greater or spleen volume of 500 mL or greater, supporting that diagnostic workup may likely be relevant.”
They stressed, however, that the study participants were asymptomatic, and the underlying reason for imaging should always be considered.
SOURCE:
The study, led by Jens Helby, MD, PhD, Copenhagen University Hospital – Rigshospitalet, Copenhagen, Denmark, was published online in JAMA Oncology.
DISCLOSURES:
The study was funded by the Danish Cancer Society, the Boserup Foundation, Copenhagen University Hospital – Rigshospitalet, and Sanofi A/S. Helby reported having financial relationships with Sanofi and Disc Medicine. Additional disclosures are available in the full article.
This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.
A version of this article first appeared on Medscape.com.
TOPLINE:
Spleen volume larger than the 99th percentile was associated with an 11-fold increased risk for hematologic cancer compared with normal volumes, with 5-year risks as high as 46% among men aged 70 years or older. Significant risks for cirrhosis and liver cancer were also seen.
METHODOLOGY:
- Splenomegaly is often detected incidentally during imaging, but guidelines vary as to the threshold that should prompt evaluation — ranging from a spleen length of 120 mm to 150 mm. However, up to 21% of healthy individuals have spleen lengths > 120 mm, which could lead to unnecessary follow-up of low-risk patients.
- Researchers used data from two general population cohorts to evaluate the relative and absolute risks for hematologic cancer and liver disease (two common causes of spleen enlargement) among individuals with incidentally detected splenomegaly. They included 8459 Danish adults (57% female; median age, 61 years) and 38,607 UK adults (51.9% female; median age, 65 years) who underwent CT or MRI scans as part of study procedures.
- Spleen length and volume measurements were available from the Danish cohort, while only spleen volume was available from the UK group.
- Participants were followed for a median of 5 years after imaging to assess the incidence of hematologic cancers (both cohorts) and cirrhosis and liver cancer (UK cohort only). Hazard ratios were adjusted for age, sex, smoking status, alcohol consumption, comorbidities, and C-reactive protein levels.
TAKEAWAY:
- In the Danish cohort, the relative risk for any hematologic cancer was significantly increased among individuals with spleen lengths above the 99th percentile (≥ 135 mm) compared with those with spleen lengths in the 26th-74th percentile (hazard ratio [HR], 5.11; P < .001). Among individuals with a spleen length ≥ 140 mm, absolute 5-year risks reached 23% for men aged 70 years or older and 12% for women in that age group.
- Risks were even more pronounced for Danish adults with a spleen volume above the 99th percentile — > 433 mL. Relative to the 26th-74th percentile, their risk for any hematologic cancer was 11-fold higher (HR, 11.08; P < .001). Among people with a spleen volume ≥ 500 mL, 5-year risks reached 46% for men aged 70 years or older and 27% for women in that age group.
- Findings were similar in the UK cohort. Among individuals with a spleen volume above the 99th percentile (> 386 mL), the risk for hematologic cancer increased nearly 12-fold (HR, 11.82; P < .001). With a spleen volume ≥ 500 mL, 5-year risks reached 21% for men aged 70 years or older and 18% for women in that age group. Relative risks were also elevated — by 1.55-2.94 — among individuals in the 75th-99th percentile (199 mL-386 mL).
- The risks for liver disease began to rise substantially at a spleen volume ≥ 400 mL. Absolute 5-year risks for cirrhosis reached 10.8% for men and 9.3% for women aged 70 years or older with a spleen volume ≥ 500 mL. For liver cancer, 5-year risks reached 3.2% and 1.2% for men and women in that age group with a spleen volume ≥ 400 mL.
IN PRACTICE:
“To our knowledge, no previous studies have examined risk of hematologic cancers by spleen length or volume in incidentally detected splenomegaly,” the authors of the study wrote. “Risk was moderately increased at spleen length of 130-139 mm or spleen volume of 400-499 mL, where diagnostic workup may be considered, and more pronounced at spleen length of 140 mm or greater or spleen volume of 500 mL or greater, supporting that diagnostic workup may likely be relevant.”
They stressed, however, that the study participants were asymptomatic, and the underlying reason for imaging should always be considered.
SOURCE:
The study, led by Jens Helby, MD, PhD, Copenhagen University Hospital – Rigshospitalet, Copenhagen, Denmark, was published online in JAMA Oncology.
DISCLOSURES:
The study was funded by the Danish Cancer Society, the Boserup Foundation, Copenhagen University Hospital – Rigshospitalet, and Sanofi A/S. Helby reported having financial relationships with Sanofi and Disc Medicine. Additional disclosures are available in the full article.
This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.
A version of this article first appeared on Medscape.com.
When Does Spleen Size Signal Cancer Risk?
When Does Spleen Size Signal Cancer Risk?