title: The effect of patient characteristics on second primary cancer risk in France.
abstract: BACKGROUND
  Although cancer survivors are known to be at greater risk of developing second primary cancer (SPC), SPC incidence estimates in France are thus far lacking. We used a multivariate approach to compute these estimates and analyzed the effect of patient characteristics (gender, age at diagnosis, first cancer site, year of diagnosis and follow-up) on SPC risk.
  
  
  METHODS
  Data from ten French population-based cancer registries were used to establish a cohort of all patients diagnosed with a first cancer between 1989 and 2004 and followed up until December 31, 2007. The person-year approach was used to estimate standardized incidence ratios (SIRs) and excess absolute risks (EARs) of metachronous SPC. Multivariate Poisson regression models were then used to model SIRs and EARs separately by gender, adjusting for age, year of diagnosis, follow-up and first cancer site.
  
  
  RESULTS
  Among the 289,967 followed-up patients with a first primary cancer, 21,226 developed a SPC. The SIR was of 1.36 (95% CI, 1.35-1.38) and the EAR was of 39.4 excess cancers per 10,000 person-years (95% CI, 37.4-41.3). Among male and female patients, multivariate analyses showed that age, year of diagnosis, follow-up and first cancer site were often independently associated with SIRs and EARs. Moreover, the EAR of SPC remained elevated during patient follow-up.
  
  
  CONCLUSIONS
  French cancer survivors face a dramatically increased risk of SPC which is probably related to the high rate of tobacco and alcohol consumption in France. Multivariate modeling of SPC risk will facilitate the construction of a tailored prediction tool to optimize SPC prevention and early detection strategies.
authors: Registre des cancers du Bas-Rhin, Laboratoire d'Épidémiologie et de Santé Publique, EA3430, FMTS, Université de Strasbourg, 4 rue Kirschleger, Strasbourg, CEDEX 67085, France. jeremie.jegu@unistra.fr.
authors: Jérémie
authors: J
authors: Jégu
authors: Marc
authors: M
authors: Colonna
authors: Laetitia
authors: L
authors: Daubisse-Marliac
authors: Brigitte
authors: B
authors: Trétarre
authors: Olivier
authors: O
authors: Ganry
authors: Anne-Valérie
authors: AV
authors: Guizard
authors: Simona
authors: S
authors: Bara
authors: Xavier
authors: X
authors: Troussard
authors: Véronique
authors: V
authors: Bouvier
authors: Anne-Sophie
authors: AS
authors: Woronoff
authors: Michel
authors: M
authors: Velten
mesh_terms: D000328:Adult; D000368:Aged; D000428:Alcohol Drinking / Q000009:adverse effects / Q000453:epidemiology / Q000208:ethnology*; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D005602:France / Q000453:epidemiology / Q000208:ethnology; D006801:Humans; D008297:Male; D008875:Middle Aged; D016609:Neoplasms, Second Primary / Q000175:diagnosis* / Q000453:epidemiology / Q000208:ethnology*; D011159:Population Surveillance / Q000379:methods; D012042:Registries; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects / Q000453:epidemiology / Q000208:ethnology*