Increased risk of second primary malignancies following uterine cancer: a population-based study in Taiwan over a 30-year periodReport as inadecuate




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BMC Cancer

, 15:393

Epidemiology, prevention and public health

Abstract

BackgroundPrevious studies assessing second primary malignancies SPMs after uterine cancer have been conducted in Western populations with conflicting results. This study aimed to define the incidence and risk of SPMs in Taiwanese patients with an initial diagnosis of uterine cancer.

MethodsUsing population-based data from the Taiwan Cancer Registry for the period 1979–2008, we quantified standardized incidence ratios SIRs among 11,571 women with an initial diagnosis of uterine cancer.

ResultsAmong the 11,571 women, 555 4.80 % developed at least one SPM during 69,987 person-years of follow-up. There was a 71 % increased risk of SPM following uterine cancer SIR = 1.71, 95 % CI, 1.57–1.86, with higher risks in the vagina-vulva SIR = 9.06, small intestine SIR = 8.45, ovary SIR = 4.15, urinary bladder SIR = 2.31, kidney SIR = 2.24, colorectum SIR = 2.24, lung SIR = 1.96, and breast SIR = 1.43. The risk of SPM was found to be the highest within the first 5 years after diagnosis of uterine cancer, with surveillance bias possibly contributing to the extremely high risk observed in the first follow-up year. The overall risk and pattern of SPM development observed in this study differed from those previously reported in Western populations, possibly because of the methodology and shorter follow-up period employed in this study. The cumulative incidence of SPMs was significantly higher in older patients ≥50 years than in younger patients P < 0.001.

ConclusionsTo our knowledge, this is the first study in an Asian population to report 71 % increased risk in SPMs in women previously diagnosed with uterine cancer. A younger age at diagnosis of uterine cancer conferred an increased risk of second malignancies, and SPMs worsened survivorship in patients who survived uterine cancer.

KeywordsUterine cancer Second primary malignancy Standardized incidence ratios AbbreviationsCIConfidence interval

EExpected number

IACRInternational Association of Cancer Registries

IARCInternational Agency for Research on Cancer

ICD-9International Classification of Diseases, 9th Revision

OObserved number

LSLynch syndrome

SEERSurveillance, Epidemiology, and End Results

SIRStandardized incidence ratio

SPMSecond primary malignancy

TCRTaiwan Cancer Registry

Kuan-Der Lee and Chao-Yu Chen contributed equally to this work.

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Author: Kuan-Der Lee - Chao-Yu Chen - Huei-Jean Huang - Ting-Yao Wang - David Teng - Shih-Hao Huang - Chyong-Huey Lai - Min-Chi Ch

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