title: Secondary cancer prevention during follow-up for endometrial cancer.
abstract: OBJECTIVE
  To conduct a population-based study of incidence and screening rates for secondary breast and colorectal cancers after endometrial cancer and to assess implications for follow-up.
  
  
  METHODS
  This was a retrospective population-based study from administrative databases. The inception cohort included all women diagnosed with endometrial cancer in Ontario, Canada from 1996 to 2000, without a previous history of breast or colorectal cancer. We ascertained 5-year recurrence and overall survival rates and practitioner type during follow-up. Primary outcomes were age-standardized incidence and screening rates of breast and colorectal cancer during follow-up compared with the general female population.
  
  
  RESULTS
  There were 3,473 women in the cohort. The 5-year recurrence rate was 15.0% and overall survival was 79.3%. Family physicians were most often involved in follow-up care. Age-standardized incidence rates of breast and colorectal cancer were 0.5% and 0.7%, respectively, compared with 0.5% (P=.76) and 0.2% (P<.001) in the general population. Age-standardized screening rates for these cancers were 64.0% and 30.0%, respectively, compared with 31.0% (P<.008) and 15.0% (P<.001) in the general population. Women aged older than 70 years and those with the lowest income were least likely to have secondary cancer screening.
  
  
  CONCLUSIONS
  Women with endometrial cancer have a comparable risk of breast cancer but higher risk of colorectal cancer compared with the general population. Follow-up after endometrial cancer should include counseling and uptake of secondary cancer prevention strategies, which will contribute to maximizing long-term survivorship for these women.
  
  
  METHODS
  II.
authors.affiliation: From the University of British Columbia, Vancouver, British Columbia; Juravinski Cancer Centre, Hamilton, Ontario; Institute for Clinical Evaluative Sciences, Toronto, Ontario; Princess Margaret Hospital, Toronto, Ontario; and University of Toronto, Ontario, Canada.
authors.forename: Janice S
authors.initials: JS
authors.lastname: Kwon
authors.forename: Laurie
authors.initials: L
authors.lastname: Elit
authors.forename: Refik
authors.initials: R
authors.lastname: Saskin
authors.forename: David
authors.initials: D
authors.lastname: Hodgson
authors.forename: Eva
authors.initials: E
authors.lastname: Grunfeld
mesh_terms: D000367:Age Factors; D000368:Aged; D001943:Breast Neoplasms / Q000453:epidemiology / Q000401:mortality / Q000556:secondary*; D015331:Cohort Studies; D015179:Colorectal Neoplasms / Q000453:epidemiology / Q000401:mortality / Q000556:secondary*; D003131:Combined Modality Therapy; D015897:Comorbidity; D016889:Endometrial Neoplasms / Q000453:epidemiology / Q000401:mortality / Q000473:pathology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008403:Mass Screening / Q000706:statistics & numerical data; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D016609:Neoplasms, Second Primary / Q000453:epidemiology* / Q000401:mortality* / Q000473:pathology; D009864:Ontario / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D016019:Survival Analysis; D013997:Time Factors