title: Second primary cancers after vulvar and vaginal cancers.
abstract: OBJECTIVE
  Our objective was to examine the occurrence of second primary cancers after vaginal and vulvar cancers.
  
  
  METHODS
  Women in whom cancers of the vagina (in situ, n=461; invasive, n=888) and vulva (in situ, n=2898; invasive, n=2685) were diagnosed between 1973 and 1988 were identified from nine population-based cancer registries. Subjects were followed through 1989 for the development of a subsequent primary cancer.
  
  
  RESULTS
  We found increased risks of all second cancers combined among women with cancer of the vulva (observed/expected in situ = 1.5; observed/expected invasive = 1.3) and vagina observed/expected invasive = 1.2). Most of the excess second cancers were smoking related (e.g., cancers of the lung, buccal cavity and pharynx, esophagus, nasal cavity and larynx) or related to infection with human papillomavirus (e.g., cervix, vulva, vagina, and anus).
  
  
  CONCLUSIONS
  These associations indicate that the follow-up care of women with cancers of the vulva and vagina should involve efforts to promote smoking cessation. The data are also consistent with a common sexually related cause for cancers of the cervix, vulva, vagina, and anus.
authors.affiliation: National Cancer Institute, Bethesda, Maryland 20852, USA.
authors.forename: S R
authors.initials: SR
authors.lastname: Sturgeon
authors.forename: R E
authors.initials: RE
authors.lastname: Curtis
authors.forename: K
authors.initials: K
authors.lastname: Johnson
authors.forename: L
authors.initials: L
authors.lastname: Ries
authors.forename: L A
authors.initials: LA
authors.lastname: Brinton
mesh_terms: D015331:Cohort Studies; D005260:Female; D006801:Humans; D008875:Middle Aged; D016609:Neoplasms, Second Primary / Q000453:epidemiology*; D027383:Papillomaviridae; D030361:Papillomavirus Infections / Q000453:epidemiology; D012307:Risk Factors; D018426:SEER Program; D012907:Smoking / Q000009:adverse effects; D014412:Tumor Virus Infections / Q000453:epidemiology; D002583:Uterine Cervical Neoplasms / Q000453:epidemiology; D014625:Vaginal Neoplasms / Q000473:pathology*; D014846:Vulvar Neoplasms / Q000473:pathology*