title: Second primary cancers following anal and cervical carcinoma: evidence of shared etiologic factors.
abstract: The authors examined the incidence of second primary cancers occurring after cervical and anal cancer. Data from the Connecticut Tumor Registry for 1935-1988 and eight other US tumor registries for 1973-1988 were used. Women with primary invasive cervical cancer had a relative risk of 4.6 (95% confidence interval (CI) 2.4-8.1) for subsequent invasive anal cancer. Increased relative risks after cervical cancer were also found for cancers of the oral cavity (relative risk (RR) = 2.2), stomach (RR = 1.5), rectum (RR = 1.4), larynx (RR = 3.4), lung (RR = 3.0), vagina (RR = 5.6), bladder (RR = 2.7), for kidney (RR = 1.9); decreased relative risks were noted for melanoma (RR = 0.5) and breast cancer (RR = 0.8). Patients with a primary diagnosis of anal cancer had relative risks for subsequent invasive and in situ cervical cancer of 1.3 (95% CI 0.2-4.5) and 3.4 (95% CI 0.9-8.8), respectively. Anal cancer was also associated with increased relative risks of subsequent lung (RR = 2.5) and prostate (RR = 1.8) cancers, whereas the relative risk of uterine cancer was 0.2 (95% CI 0.0-0.9). These findings support other evidence for common factors, such as human papillomavirus infection and cigarette smoking, in the etiology of cervical and anal cancer.
authors.affiliation: Viral Epidemiology Section, National Cancer Institute, Bethesda, MD.
authors.forename: C S
authors.initials: CS
authors.lastname: Rabkin
authors.forename: R J
authors.initials: RJ
authors.lastname: Biggar
authors.forename: M
authors.initials: M
authors.lastname: Melbye
authors.forename: R E
authors.initials: RE
authors.lastname: Curtis
mesh_terms: D001005:Anus Neoplasms / Q000150:complications / Q000453:epidemiology* / Q000209:etiology; D015982:Bias; D015986:Confounding Factors, Epidemiologic; D003237:Connecticut / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008403:Mass Screening; D016609:Neoplasms, Second Primary / Q000150:complications / Q000453:epidemiology* / Q000209:etiology; D027383:Papillomaviridae; D011159:Population Surveillance; D012042:Registries; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects; D014412:Tumor Virus Infections / Q000150:complications; D014481:United States / Q000453:epidemiology; D002583:Uterine Cervical Neoplasms / Q000150:complications / Q000453:epidemiology* / Q000209:etiology