Second primary tumors following tobacco dependence treatments among head and neck cancer patients.
OBJECTIVE
To estimate the cumulative percentage of second primary tumors (SPTs) in head and neck (H&N) cancer patients and primary cancers in general Nicotine Dependence Center (NDC) population controls following tobacco dependence consultation seen between 1988 and 2001.


METHODS
A 1:1 matched pair design and a stratified Cox proportional hazard model were used. General NDC population controls were matched on age, gender, and NDC consult (type and date) to the H&N cancer patients. The study population included 101 H&N cancer patients (66 male, 35 female) with mean (SD) age of 58.7 (10.1) years.


RESULTS
Baseline demographics and length of follow-up were similar between groups. However, H&N cancer patients smoked more cigarettes per day than controls (P < 0.003). For H&N cancer patients, the median time from initial H&N cancer diagnosis to NDC consult was 7 months (range, 0-292 months). Following the NDC consult, 27 H&N cancer patients developed 32 SPTs; whereas among the controls, 12 patients developed 12 other cancers (P = 0.013). There was no difference in the development of non-tobacco-related cancers (P = 0.273). However, H&N cancer patients were more likely to develop tobacco-related cancers (P = 0.01). Furthermore, there was a trend where the H&N cancer patients who continued to use tobacco were more likely to develop tobacco-related cancers than those who remained abstinent (P = 0.10).


CONCLUSIONS
These findings confirm that H&N cancer patients are more prone to the development of tobacco-related cancers. Further, these findings suggest that H&N cancer patients who stop using tobacco are able to decrease the development of tobacco-related SPTs.
Garces
Yolanda I
YI
Division of Radiation Oncology, Mayo Clinic College of Medicine, Rochester, MN 55905, USA. garces.yolanda@mayo.edu
Schroeder
Darrell R
DR
Nirelli
Liza M
LM
Croghan
Gary A
GA
Croghan
Ivana T
IT
Foote
Robert L
RL
Hurt
Richard D
RD
D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006258:Head and Neck Neoplasms / Q000628:therapy*; D006801:Humans; D008297:Male; D008487:Medical History Taking; D008875:Middle Aged; D016609:Neoplasms, Second Primary / Q000453:epidemiology*; D012189:Retrospective Studies; D016540:Smoking Cessation / Q000706:statistics & numerical data; D014029:Tobacco Use Disorder / Q000150:complications* / Q000453:epidemiology