Risk of second primary cancer among patients with head and neck cancers: A pooled analysis of 13 cancer registries.
The objective of the study was to assess the risk of second primary cancers (SPCs) following a primary head and neck cancer (oral cavity, pharynx and larynx) and the risk of head and neck cancer as a SPC. The present investigation is a multicenter study from 13 population-based cancer registries. The study population involved 99,257 patients with a first primary head and neck cancer and contributed 489,855 person-years of follow-up. To assess the excess risk of SPCs following head and neck cancers, we calculated standardized incidence ratios (SIRs) by dividing the observed numbers of SPCs by the expected number of cancers calculated from accumulated person-years and the age-, sex- and calendar period-specific first primary cancer incidence rates in each of the cancer registries. During the observation period, there were 10,826 cases of SPCs after head and neck cancer. For all cancer sites combined, the SIR of SPCs was 1.86 (95% CI = 1.83-1.90) and the 20-year cumulative risk was 36%. Lung cancer contributed to the highest proportion of the SPCs with a 20-year cumulative risk of 13%. Excess second head and neck cancer risk was observed 10 years after diagnosis with lymphohaematopoietic cancers. The most common SPC following a first primary head and neck cancer was lung cancer. However, the highest excess of SPCs was in the head and neck region. These patterns were consistent with the notion that the pattern of cancer in survivors of head and neck cancer is dominated by the effect of tobacco smoking and alcohol drinking.
Chuang
Shu-Chun
SC
International Agency for Research on Cancer (IARC), Lyon, France.
Scelo
Ghislaine
G
Tonita
Jon M
JM
Tamaro
Sharon
S
Jonasson
Jon G
JG
Kliewer
Erich V
EV
Hemminki
Kari
K
Weiderpass
Elisabete
E
Pukkala
Eero
E
Tracey
Elizabeth
E
Friis
Soren
S
Pompe-Kirn
Vera
V
Brewster
David H
DH
Martos
Carmen
C
Chia
Kee-Seng
KS
Boffetta
Paolo
P
Brennan
Paul
P
Hashibe
Mia
M
D000368:Aged; D005260:Female; D006258:Head and Neck Neoplasms / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D016609:Neoplasms, Second Primary / Q000453:epidemiology*; D012042:Registries; D012307:Risk Factors; D015996:Survival Rate