title: Incidence of multiple primary cancers following respiratory tract cancer in Umbria, Italy.
abstract: Improvements in cancer survival and life expectancy have placed a focus on long-term risks following a primary cancer, including that of developing other primary malignancies. The purpose of this study was to evaluate the risk, in patients with respiratory tract cancers, of developing a second primary malignancy.
  
  
  METHODS
  Standardized incidence ratios (SIR) of observed to expected cases were calculated for residents of Umbria diagnosed with laryngeal and lung cancer between 1994 and 2008. Significance and 95% confidence intervals were determined assuming a Poisson distribution.
  
  
  RESULTS
  In total, 189 and 340 cases of second primary cancers were observed respectively among laryngeal and lung cancer patients. Male laryngeal cancer patients were found to have a significantly increased risk of lung cancer (SIR=4.10), non-melanoma skin cancer (SIR=2.10), bladder cancer (SIR=2.25) and pancreatic cancer (SIR=3.85). In females, a significantly increased risk was observed only when all sites combined were considered. Male lung cancer patients were found to have a significantly increased risk for laryngeal cancer (SIR=4.36), esophageal cancer (SIR=3.97), kidney cancer (SIR=3.40), multiple myeloma and malignant plasma cell neoplasm (SIR=2.97), bladder cancer (SIR=2.20) and non-melanoma skin cancer (SIR=1.55). In females, the risk of developing a second cancer was higher but was not significant for non-melanoma skin cancers, colon and breast cancer.
  
  
  CONCLUSIONS
  Study results show an excess risk of other primary malignancies in respiratory tract cancer patients, particularly males. This may be due to shared risk factors, genetic susceptibility, effect of first cancer treatments and increased diagnostic surveillance.
authors.affiliation: Umbrian Population Cancer Registry, Dept of Medical-surgical Specialties and Public Health, University of Perugia.
authors.forename: Maria Saba
authors.initials: MS
authors.lastname: Petrucci
authors.affiliation: Umbrian Population Cancer Registry, Dept of Medical-surgical Specialties and Public Health, University of Perugia.
authors.forename: Valerio
authors.initials: V
authors.lastname: Brunori
authors.affiliation: Umbrian Population Cancer Registry, Dept of Medical-surgical Specialties and Public Health, University of Perugia.
authors.forename: Giuseppe Michele
authors.initials: GM
authors.lastname: Masanotti
authors.affiliation: Umbrian Population Cancer Registry, Dept of Medical-surgical Specialties and Public Health, University of Perugia.
authors.forename: Fortunato
authors.initials: F
authors.lastname: Bianconi
authors.affiliation: Umbrian Population Cancer Registry, Dept of Medical-surgical Specialties and Public Health, University of Perugia.
authors.forename: Francesco
authors.initials: F
authors.lastname: La Rosa
authors.affiliation: Umbrian Population Cancer Registry, Dept of Medical-surgical Specialties and Public Health, University of Perugia.
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Stracci
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D015994:Incidence; D007558:Italy / Q000453:epidemiology; D007822:Laryngeal Neoplasms; D008175:Lung Neoplasms; D008297:Male; D016609:Neoplasms, Second Primary / Q000453:epidemiology*; D018570:Risk Assessment