title: Second primary tumors following tobacco dependence treatments among head and neck cancer patients.
abstract: 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.
authors.affiliation: Division of Radiation Oncology, Mayo Clinic College of Medicine, Rochester, MN 55905, USA. garces.yolanda@mayo.edu
authors.forename: Yolanda I
authors.initials: YI
authors.lastname: Garces
authors.forename: Darrell R
authors.initials: DR
authors.lastname: Schroeder
authors.forename: Liza M
authors.initials: LM
authors.lastname: Nirelli
authors.forename: Gary A
authors.initials: GA
authors.lastname: Croghan
authors.forename: Ivana T
authors.initials: IT
authors.lastname: Croghan
authors.forename: Robert L
authors.initials: RL
authors.lastname: Foote
authors.forename: Richard D
authors.initials: RD
authors.lastname: Hurt
mesh_terms: 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