TY - JOUR
T1 - Risk of second primary malignancies in women with cervical cancer
T2 - A population-based study in Taiwan over a 30-year period
AU - Chen, Chao Yu
AU - Lai, Chyong-Huey
AU - Lee, Kuan-Der
AU - Huang, Shih Hao
AU - Dai, Yen Mei
AU - Chen, Min Chi
PY - 2012/12
Y1 - 2012/12
N2 - Objective: Studies conducted in Western countries have reported an increased risk for second primary malignancies after cervical cancer. There is little documentation of ethnic differences in this increased risk, and most of the Asian studies are hospital-based studies with small case numbers. Methods: Using population-based data from the Taiwan Cancer Registry for the period 1979-2008, we quantified standardized incidence ratios (SIRs) among 52,972 women with initial diagnoses of cervical cancer. Results: Among the 52,972 women, 3061 (5.78%) developed second primary cancers during 433,571 person-years of follow-up. Overall, the SIR for developing a subsequent second cancer was significantly greater than that of the general population (1.36 [95% CI, 1.32-1.41]). There was a greater risk for cancers of the esophagus, stomach, small intestine, rectum, lung, bone, non-melanoma skin, uterine corpus, vagina/vulva, bladder, kidney, and leukemia. When further examining age at diagnosis of cervical cancer (< 50 and ≥ 50) for these 12 sites, we found that the risk of second cancers (SIR, < 50 and ≥ 50: 3.08 vs. 1.63) was higher not only in younger patients, except for non-melanoma skin cancer and endometrial cancer, but also within the first 5 years after diagnosis of cervical cancer. The median overall survival for women with cervical cancer was 18.58 years. The second cancers had a negative impact on overall survival after adjusting for age (P < 0.001). Conclusions: SIR for second cancers was significantly greater than the general population in cervical cancer patients. A young age at the diagnosis of cervical cancer predicted an increased risk. The second cancers worsened overall survival.
AB - Objective: Studies conducted in Western countries have reported an increased risk for second primary malignancies after cervical cancer. There is little documentation of ethnic differences in this increased risk, and most of the Asian studies are hospital-based studies with small case numbers. Methods: Using population-based data from the Taiwan Cancer Registry for the period 1979-2008, we quantified standardized incidence ratios (SIRs) among 52,972 women with initial diagnoses of cervical cancer. Results: Among the 52,972 women, 3061 (5.78%) developed second primary cancers during 433,571 person-years of follow-up. Overall, the SIR for developing a subsequent second cancer was significantly greater than that of the general population (1.36 [95% CI, 1.32-1.41]). There was a greater risk for cancers of the esophagus, stomach, small intestine, rectum, lung, bone, non-melanoma skin, uterine corpus, vagina/vulva, bladder, kidney, and leukemia. When further examining age at diagnosis of cervical cancer (< 50 and ≥ 50) for these 12 sites, we found that the risk of second cancers (SIR, < 50 and ≥ 50: 3.08 vs. 1.63) was higher not only in younger patients, except for non-melanoma skin cancer and endometrial cancer, but also within the first 5 years after diagnosis of cervical cancer. The median overall survival for women with cervical cancer was 18.58 years. The second cancers had a negative impact on overall survival after adjusting for age (P < 0.001). Conclusions: SIR for second cancers was significantly greater than the general population in cervical cancer patients. A young age at the diagnosis of cervical cancer predicted an increased risk. The second cancers worsened overall survival.
KW - Cervical cancer
KW - Second primary malignancy
KW - Standardized incidence ratios
KW - Taiwan Cancer Registry
UR - http://www.scopus.com/inward/record.url?scp=84868575231&partnerID=8YFLogxK
U2 - 10.1016/j.ygyno.2012.09.004
DO - 10.1016/j.ygyno.2012.09.004
M3 - 文章
C2 - 22975362
AN - SCOPUS:84868575231
SN - 0090-8258
VL - 127
SP - 625
EP - 630
JO - Gynecologic Oncology
JF - Gynecologic Oncology
IS - 3
ER -