The Bidirectional Association between Uterine Cancer and Other Female Cancers

It has been reported that uterine cancer remains the most common gynecologic malignancy in western countries. In Taiwan, having been the 13th leading cancer in women in 1995 and the 6th in 2010, the incidence of uterine cancer arose from 2.86 per 100,000 in 1995 to 15.07 per 100,000 in 2010. To be noted, uterine cancer was ranked 1st among gynecologic cancers in 2010 for the very first time. Uterine cancer is typified as a relatively high cure rate and good survivorship. As a result, an important issue for these long term uterine cancer survivors is the risk of second cancers. In contrast, for those developed uterine cancer as second malignancy, the various types of first primary cancer are critical to evaluate possible bidirectional associations. Since 2008, we have reported the SPMs for some Taiwan characteristic malignancies, such as nasopharyngeal cancer, young-age breast cancer, oral/pharyngeal cancers, and cervical cancer. Clusters of second cancers provide a unique clue to the understanding of cancer etiology and its mechanisms. Multiple cancers could be due to common risk factors of treatment for the first cancer. If the risk increases over time, the association may be more likely to be due to treatment for the first cancer. Otherwise, if an association treating the index cancer as the second cancer is observed, then common risk factors may be suggested for the association. The discovery of such relationship between uterine and other cancer sites may provide important clues to their shared genetic or environmental factors. Once the shared factors are identified, preventions based on these risk factors will decrease the chance of developing both cancers simultaneously. To achieve this object, we propose a two-year project in which we aim to use the national database from Taiwan Cancer Registry between 1979 and 2008 (1) to assess the incidence of second cancer in the patients diagnosed with a first primary uterine cancer, (2) to assess the risk of second primary uterine cancer after first primary cancers of various types, (3) to determine whether associations are likely to be caused by common etiologic factors or treatment, and (4) to evaluate survivorship for the patients with index uterine and second uterine cancer, respectively . We will address the relationship between uterine cancer and other cancer sites with respect to their standardized incidence ratios (SIRs), cumulative incidence, age-trend risk, and will evaluate the impact of SPMs on survivorship. This innovative study may help illustrate the implications of common genetic or environmental susceptibility between two cancer sites, particularly in Asian populations.

Project ID:PC10301-0541
External Project ID:NSC102-2314-B182-062-MY2