title: Risk of subsequent primary neoplasms developing in lung cancer patients with prior malignancies.
abstract: BACKGROUND
  This study was performed to test the hypothesis that a history of other primary neoplasms before a lung cancer diagnosis increases the risk of subsequent malignancy.
  
  
  METHODS
  Of 8363 lung cancer patients seen from 1978 to 2002, 881 (11%) had at least 1 previous nonlung primary malignancy. Charts were analyzed for the occurrence of subsequent malignancies.
  
  
  RESULTS
  Lung cancer diagnosis in 881 patients consisted of 75% non-small cell, 12% small cell, and 13% other histologies. The median age was 66 years, with 56% male, 76% white, and 86% smokers. Of the 881 patients, 92% had no subsequent cancer (group 1), and 8% went on to experience the development of a new primary neoplasm (including lung) after their lung cancer (group 2). After adequate follow-up, the cumulative probability of developing a subsequent cancer did not differ markedly between those with and without a prior non-lung cancer diagnosis at 2 years (12% vs 10%) or 5 years (16% vs 15%). Group 1 patients had a significantly lower 1- and 5-year survival than group 2 patients (59% vs 48% and 29% vs 17%, respectively; P =.008). Although multivariate analysis suggested that stage, history of tobacco-associated neoplasm, and history of definitive surgical resection were important determinants in predicting long-term survival, a prior malignancy was not an independent risk factor in the development of subsequent malignancy.
  
  
  CONCLUSIONS
  The risk of developing a subsequent malignancy is very high in lung cancer patients with prior primary malignancies, but it is not markedly different from the risks experienced by patients with no prior malignancies.
authors.affiliation: Johns Hopkins Medical Institutions, Baltimore, MD, USA.
authors.forename: Malcolm V
authors.initials: MV
authors.lastname: Brock
authors.forename: Anthony J
authors.initials: AJ
authors.lastname: Alberg
authors.forename: Craig M
authors.initials: CM
authors.lastname: Hooker
authors.forename: Anne L
authors.initials: AL
authors.lastname: Kammer
authors.forename: Li
authors.initials: L
authors.lastname: Xu
authors.forename: Carmen M
authors.initials: CM
authors.lastname: Roig
authors.forename: Stephen C
authors.initials: SC
authors.lastname: Yang
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015142:Baltimore / Q000453:epidemiology; D002289:Carcinoma, Non-Small-Cell Lung / Q000453:epidemiology* / Q000209:etiology / Q000473:pathology; D018288:Carcinoma, Small Cell / Q000453:epidemiology / Q000209:etiology / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008175:Lung Neoplasms / Q000453:epidemiology* / Q000209:etiology / Q000473:pathology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D009378:Neoplasms, Multiple Primary / Q000453:epidemiology* / Q000209:etiology / Q000473:pathology; D011237:Predictive Value of Tests; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects; D016019:Survival Analysis; D013997:Time Factors