Second primary cancers and recurrence in patients after resection of colorectal cancer: An integrated analysis of trials by Japan Clinical Oncology Group: JCOG0205, JCOG0212, JCOG0404 (JCOG1702A).

561 Background: Improvements in early detection and treatment have resulted in an increasing number of long-term survivors of colorectal cancer (CRC). For the survivors, Second primary cancers and recurrence are important issues, but the evidence for appropriate surveillance strategy is limited. The aim of this study was to investigate the frequency and the timing of second primary cancers and recurrence in patients (pts) after surgery using 3 randomized trials (J0205, J0212 and J0404) conducted by Colorectal Cancer Study Group of JCOG. Methods: Eligibility criteria included histologically proven CRC and having received surgery. The timing, site and frequency of second primary cancer and recurrence were investigated. Risk factors associated with the events were explored. Standardized incidence ratio (SIR) about second primary cancer compared with national database of Japan Cancer Registry was estimated. Results: A total of 2,824 pts with a median follow-up time of 6 years were included. Median age was 62 years old (23-75), male/female was 58%/42%, and stage 0/I/II/III/IV was 0.2%/8.7%/25.4%/64.8%/0.9%. Pts with 5-FU based adjuvant chemotherapy were 63%. Cumulative incidence of second primary cancer increased constantly over time (Table). Among 240 pts, the most common site was lung (37), stomach (35) and colon (32). In multivariable analysis, age (over 64 years old) and sex (male) were risk factors (age HR: 1.60 (95% CI: 1.24-2.07), sex HR: 1.36 (95% CI: 1.04-1.78)). The SIR of any second primary cancers was 1.07 (95% CI: 0.94-1.21). The SIR for second primary cancers of colon was 1.09 (95% CI: 0.79-1.47). On the other hand, cumulative incidence of recurrence almost reached at 3 years. Conclusions: Common surveillance strategy can be applied even for curatively resected CRC pts after 3 years from surgery, because the risk of second primary cancer was almost same as general population over time. The necessity of intensive follow-up to detect recurrence decreases after 3 years. [Table: see text]

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Second primary cancers and recurrence in patients after resection of colorectal cancer: An integrated analysis of trials by Japan Clinical Oncology Group: JCOG1702A

Japanese Journal of Clinical Oncology ◽

10.1093/jjco/hyaa184 ◽

2020 ◽

Author(s):

Kiyo Tanaka ◽

Gakuto Ogawa ◽

Junki Mizusawa ◽

Tomohiro Kadota ◽

Kenichi Nakamura ◽

...

Keyword(s):

Colorectal Cancer ◽

General Population ◽

Cumulative Incidence ◽

National Database ◽

Integrated Analysis ◽

Second Primary ◽

Primary Cancer ◽

Second Primary Cancer ◽

Surveillance Strategy ◽

Second Primary Cancers

Abstract Background Improvements in early detection and treatment have resulted in an increasing number of long-term survivors of colorectal cancer (CRC). For the survivors, second primary cancer and recurrence are important issues; however, evidence for an appropriate surveillance strategy remains limited. This study aimed to investigate the frequency and timing of second primary cancer in patients after surgery for exploring an appropriate surveillance strategy by using an integrated analysis of three large-scale randomized controlled trials in Japan. Methods The eligibility criteria of three trials included histologically confirmed CRC and having received surgery. The timing, site and frequency of second primary cancers and recurrence were investigated. Risk factors associated with second primary cancers were also examined. The standardized incidence ratio (SIR) of second primary cancers compared with the national database of the Japan Cancer Registry was estimated. Results A total of 2824 patients were included in this study. The cumulative incidence of second primary cancer increased over time. The SIR of any second primary cancer was 1.07 (95% CI: 0.94–1.21). The SIR for second primary cancers of colon was 1.09 (95% CI: 0.79–1.47). The cumulative incidence of recurrence almost reached plateau at 3 years. Conclusions A common surveillance strategy for the general population can be applied even for curatively resected CRC patients, as the risk of second primary cancers was almost the same as that of the general population.

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Incidence and Risk Factors of Second Primary Cancer after the Initial Primary Human Papillomavirus Related Neoplasms

10.1101/2020.01.29.19004507 ◽

2020 ◽

Author(s):

Jiayi Shen ◽

Huaqiang Zhou ◽

Jiaqing Liu ◽

Zhonghan Zhang ◽

Wenfeng Fang ◽

...

Keyword(s):

Risk Factors ◽

Human Papillomavirus ◽

Cumulative Incidence ◽

Reference Population ◽

Specific Reference ◽

Second Primary ◽

Primary Cancer ◽

Second Primary Cancer ◽

Standardized Incidence Ratio ◽

Subdistribution Hazard

AbstractBackgroundHuman papillomavirus (HPV)-related cancers are nowadays associated with better survival. However, comprehensive studies in second primary cancer (SPC) after the initial primary HPV-related cancer still remain warranted. Therefore, this study was designed to analyse the incidence and risk factors of SPC after HPV-related cancer.MethodsWe identified 86,790 patients diagnosed with initial primary HPV-related cancer between 1973 and 2010 in the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) 9 database. Standardized incidence ratio (SIR) and cumulative incidence were calculated to assess the risk of SPC after HPV-related cancer. Subdistribution hazard regression was also conducted to figure out the risk factors.ResultsSIR of SPC after HPV-related cancer was 1.60 (95% confidence interval [CI] 1.55-1.65) for male and 1.25 (95% CI 1.22-1.28) for female. SIR of second primary HPV-related cancer (7.39 [95% CI 6.26-8.68] male and 4.35 [95% CI 4.04-4.67] female) was obviously higher than that of second primary HPV-unrelated cancer (1.54 [95% CI 1.49-1.60] male and 1.16 [95% CI 1.13-1.19] female). 5-year cumulative incidence of SPC was 7.22% (95% CI 6.89%-7.55%) for male and 3.72% (95% CI 3.58%-3.88%) for female. Risk factors of SPC included being married and initial primary cancer (IPC) diagnosed at earlier stage for both gender, and IPC diagnosed at older age as well as surgery performed for female only.ConclusionPatients diagnosed with HPV-related cancer are more likely to develop another primary cancer, as compared with the age-specific reference population. Patients with the risk factors claimed in this study are suggested to screen for SPC regularly. According to the elevation of SIR of HPV-related SPC, it is suggested that part of the HPV-related SPC cases may be caused by the persistent infection of HPV.

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239Incidence and potential risk factors of a second primary cancer among 217,702 colorectal cancer survivors

International Journal of Epidemiology ◽

10.1093/ije/dyab168.388 ◽

2021 ◽

Vol 50 (Supplement_1) ◽

Author(s):

Yingju Tseng ◽

Linda Liang ◽

Stefanie J Klug

Keyword(s):

Colorectal Cancer ◽

Risk Factors ◽

Cancer Survivors ◽

Potential Risk ◽

Tumour Size ◽

Second Primary ◽

Primary Cancer ◽

Second Primary Cancer ◽

Increased Risk ◽

Potential Risk Factors

Abstract Background Survival of colorectal cancer (CRC) has improved markedly but risk of an independent second primary cancer (SPC) increases. We determined incidence and potential risk factors of SPC following CRC. Methods We obtained data from 217,202 CRC cases (ICD-10 C18-C20, aged ≥20 years) diagnosed between 1990-2013 from the German Centre for Cancer Registry Data. Cancers arising in a distinct site (excluding non-melanoma skin cancer) and/or of a different histology group were classified as SPCs. Standardised incidence ratios (SIR) and 95% confidence intervals compared the excess risk to the general population, stratified by age, sex and CRC sub-site. Cox proportional hazards models identified potential risk factors of SPC. Results Following CRC (median age 70 years), 18,751 SPCs occurred (8.63%; median age 69 years). SPC incidence increased by 36% in males (SIR: 1.36 [1.34-1.38]), 46% in females (SIR: 1.46 [1.43-1.49]) and doubled for cases <65 years (SIR: 2.08 [1.99-2.17]). Common SPC sites following colon cancer included the small intestine, stomach, liver, pancreas, bladder and kidney. Common male-specific sites included prostate and in females: breast, uterus and ovary. Similar sites were observed following rectal cancer, particularly in cases <65 years. Age, male sex and tumour size (T1, T2) were potential risk factors of SPC. Therapy of CRC (including radiotherapy) did not demonstrate an elevated risk. Conclusions CRC survivors have an increased risk of SPC, particularly due to age, sex and tumour size. Key messages Colorectal cancer survivors have an increased risk of a SPC. Age, sex and tumour size are associated risk factors.

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Prediagnosis Smoking, Obesity, Insulin Resistance, and Second Primary Cancer Risk in Male Cancer Survivors: National Health Insurance Corporation Study

Journal of Clinical Oncology ◽

10.1200/jco.2006.10.3416 ◽

2007 ◽

Vol 25 (30) ◽

pp. 4835-4843 ◽

Cited By ~ 57

Author(s):

Sang Min Park ◽

Min Kyung Lim ◽

Kyu Won Jung ◽

Soon Ae Shin ◽

Keun-Young Yoo ◽

...

Keyword(s):

Risk Factors ◽

Insulin Resistance ◽

Health Insurance ◽

Cancer Survivors ◽

National Health Insurance ◽

National Health ◽

Smoking History ◽

Second Primary ◽

Primary Cancer ◽

Second Primary Cancer

Purpose Smoking, obesity, and insulin resistance are well-known risk factors for cancer, yet few epidemiology studies evaluate their role as risk factors for a second primary cancer (SPC). Patients and Methods We identified 14,181 men with a first cancer from the National Health Insurance Corporation Study cohort. We obtained data on fasting glucose level, body mass index (BMI), and smoking history from an enrollment interview (1996). We obtained SPC incidence data for 1996 through 2002 from the Korean Central Cancer Registry. We used the standard Poisson regression model to estimate the age- and multivariate-adjusted relative risk (RR) for SPCs in relation to smoking history, BMI, and insulin resistance before diagnosis. Results We observed 204 patients with SPC. The overall age-standardized incidence rate of SPC was 603.2 occurrences per 100,000 person-years, which was about 2.3 times higher than that of first cancer in the general male population. Multivariate regression revealed that lung (RR, 3.69; 95% CI, 1.35 to 10.09) and smoking-related (RR, 2.02; 95% CI, 1.02 to 4.03) SPCs were significantly associated with smoking. Obese patients (BMI ≥ 25 kg/m2) had significantly elevated RRs for colorectal (RR, 3.45; 95% CI, 1.50 to 7.93) and genitourinary (RR, 3.61; 95% CI, 1.36 to 9.54) SPCs. Patients with a fasting serum glucose concentration ≥ 126 mg/dL had a higher RR for hepatopancreatobiliary (RR, 3.33; 95% CI, 1.33 to 8.37) and smoking-related (1.93; 95% CI, 1.01 to 3.68) SPCs. Conclusion Prediagnosis smoking history, obesity, and insulin resistance were risk factors for several SPCs. These findings suggest that more thorough surveillance and screening for SPCs is needed for the cancer survivors with these risk factors.

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Development of second primary cancers in breast cancer survivors.

Journal of Clinical Oncology ◽

10.1200/jco.2016.34.3_suppl.257 ◽

2016 ◽

Vol 34 (3_suppl) ◽

pp. 257-257

Author(s):

Hong Kyu Jung ◽

Jihyoun Lee ◽

Zisun Kim ◽

Min Hyuk Lee ◽

Ilkyun Lee

Keyword(s):

Breast Cancer ◽

Endometrial Cancer ◽

Thyroid Cancer ◽

Cancer Survivors ◽

Breast Cancer Survivors ◽

Second Primary ◽

Primary Cancer ◽

Second Primary Cancer ◽

Breast Cancer Patients ◽

Second Primary Cancers

257 Background: Breast cancer survivors have slightly increased risk of second primary cancers. Importance of screening for second cancers has been raised due to increased survival in those populations. Not only having genetic risk such as BRCA mutation, but also treatment-related risk presents. The most common second primary cancer is breast cancer. Colon cancer, uterine cancer, and ovarian cancer showed increased cumulative incidence. In this study, we assessed development second primary cancers in breast cancer survivors. Methods: Medical record of breast cancer patients was reviewed retrospectively in three tertiary medical institutions. Available data of ICD-9 record after breast cancer diagnosis was evaluated. Diagnosis of second primary breast cancer was excluded in evaluation. Results: Since Jan 1989 to Jan 2014, available medical records were reviewed in breast cancer patients(N = 5880) in three institutions(one urban and the other two rural institutions). Cumulative incidence of overall second primary cancers was 4.57%. Among 269 second primary cancers, thyroid cancer(44.2%) was most common second primary cancer, followed by gastric cancer(10.0%). Gastric cancers were more common in rural institution than urban area(14.2 % vs 5.5%), while incidence of thyroid cancer is elevated in urban institution(57.8% vs 31.9%). Among 9 patients who has been diagnosed endometrial cancer, 7 patients had history of selective estrogen receptor modulator(tamoxifen or toremifen) treatment. Development of lung cancer was not related to breast cancer radiation treatment(4 of 15 patients). Leukemia after breast cancer treatment was diagnosed in 5 patients (8.5% of second primary cancers), three of them were adult T cell leukemia and two of them were acute myeloid leukemia. Conclusions: Incidence of cancer in general population was reflected to development of second primary cancer in breast cancer survivors. Endocrine treatment was related increased incidence of endometrial cancer, respectively. Application of personalized cancer screening plan would be important in this patient group.

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