Second primary lung cancer after head and neck squamous cell cancer: population-based study of risk factors.
BACKGROUND
Patients with head and neck squamous cell cancer (HNSCC) are at risk of developing second primary lung cancer (SPLC).


METHODS
Among 61,883 patients with HNSCC from the Surveillance, Epidemiology and End Results (SEER) database, 4522 developed SPLC (any histology) ≥2 months after HNSCC. We correlated risk with demographic and tumor-related parameters.


RESULTS
The risk of SPLC after HNSCC was 5.8%, 11.4%, and 16.4% at 5, 10, and 15 years, respectively. From Cox regression, significantly adverse (p < .0001) risk factors for SPLC included: regional versus localized HNSCC stage (hazard ratio [HR] = 1.16), hypopharyngeal or supraglottic laryngeal site (HR = 1.57), increased age (HR = 1.26/decade), black race (HR = 1.27), and male sex (HR = 1.26). Glottic (HR = 0.75) and tonsillar or oral cavity sites (HR = 0.80) were associated with significantly (p < .0001) lower risks of SPLC.


CONCLUSIONS
From population-based actuarial analyses, HNSCCs with more aggressive clinicopathologic features were more apt to develop SPLC, suggestive of similar environmental and/or host factors for these cancers.
Department of Radiation Oncology, University of Rochester Medical Center, Rochester, NY 14642, USA. MTMilano@yahoo.com
Michael T
MT
Milano
Carl R
CR
Peterson
Hong
H
Zhang
Deepinder P
DP
Singh
Yuhchyau
Y
Chen
D000328:Adult; D001741:Black or African American; D000367:Age Factors; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000473:pathology*; D005260:Female; D006258:Head and Neck Neoplasms / Q000473:pathology*; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000473:pathology; D007822:Laryngeal Neoplasms / Q000473:pathology; D008175:Lung Neoplasms / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016609:Neoplasms, Second Primary / Q000453:epidemiology*; D012307:Risk Factors; D018426:SEER Program; D012737:Sex Factors; D000077195:Squamous Cell Carcinoma of Head and Neck; D014481:United States / Q000453:epidemiology