Second primary cancers in patients with cutaneous malignant melanoma: a population-based study in Sweden.
To quantify the risk of second primary cancers among patients with cutaneous malignant melanoma, we studied 20,354 patients in the Swedish Cancer Register during 1958-88. A second primary cancer was reported in 1605 patients, compared with an expected number of 1109.5 [standardised incidence ratio (SIR) = 1.45, 95% confidence interval (CI) = 1.38-1.52]. The highest risk was found among patients younger than 60 years. The greatest risk was seen during the first year after diagnosis (SIR = 1.91, CI = 1.69-2.14), but even after long-term follow-up--15 years or more--the risk was still significantly elevated (SIR = 1.56, CI = 1.35-1.79). The strongest association was found for a second primary malignant melanoma (men, SIR = 10.0, CI = 8.26-12.00; women, SIR = 8.66, CI = 7.22-10.30) and non-melanoma skin cancer (men, SIR = 3.58, CI = 2.85-4.44; women, SIR = 2.41, CI = 1.71-3.29). The risk of second cancers associated with tissues of neuroectodermal origin was increased, especially tumours of the nervous system (men, SIR = 1.73, CI = 1.10-2.60; women, SIR = 2.03, CI = 1.45-2.78). The SIR of second cancers involving the immune system was also increased. An excess risk of endometrial cancer was seen (SIR = 1.41, CI = 1.03-1.88), but no significant associations existed for cancers of the breast, ovary, testis or other endocrine glands. Among tumours of the digestive tract, only colon cancer in men had a significantly increased SIR (1.33, CI = 1.00-1.74).
Department of Cancer Epidemiology, University Hospital, Uppsala, Sweden.
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C
Wassberg
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Thörn
J
J
Yuen
U
U
Ringborg
T
T
Hakulinen
D000367:Age Factors; D015331:Cohort Studies; D003110:Colonic Neoplasms / Q000453:epidemiology; D016889:Endometrial Neoplasms / Q000453:epidemiology; D005260:Female; D006801:Humans; D007160:Immunoproliferative Disorders / Q000453:epidemiology; D015994:Incidence; D008297:Male; D008545:Melanoma / Q000453:epidemiology*; D008875:Middle Aged; D016609:Neoplasms, Second Primary / Q000453:epidemiology*; D009423:Nervous System Neoplasms / Q000453:epidemiology; D017599:Neuroectodermal Tumors / Q000453:epidemiology; D016012:Poisson Distribution; D012042:Registries; D018570:Risk Assessment; D012307:Risk Factors; D012737:Sex Factors; D012878:Skin Neoplasms / Q000453:epidemiology*; D013548:Sweden / Q000453:epidemiology