title: Multiple primary cancers associated with Merkel cell carcinoma in Queensland, Australia, 1982-2011.
abstract: The relatively high incidence of Merkel cell carcinoma (MCC) in Queensland provides a valuable opportunity to examine links with other cancers. A retrospective cohort study was performed using data from the Queensland Cancer Registry. Standardized incidence ratios (SIRs) were used to approximate the relative risk of being diagnosed with another primary cancer either following or prior to MCC. Patients with an eligible first primary MCC (n = 787) had more than double the expected number of subsequent primary cancers (SIR = 2.19, 95% confidence interval (CI) = 1.84-2.60; P<0.001). Conversely, people who were initially diagnosed with cancers other than MCC were about two and a half times more likely to have a subsequent primary MCC (n=244) compared with the general population (SIR = 2.69, 95% CI = 2.36-3.05; P<0.001). Significantly increased bi-directional relative risks were found for melanoma, lip cancer, head and neck cancer, lung cancer, myelodysplastic diseases, and cancer with unknown primary site. In addition, risks were elevated for female breast cancer and kidney cancer following a first primary MCC, and for subsequent MCCs following first primary colorectal cancer, prostate cancer, non-Hodgkin lymphoma, or lymphoid leukemia. These results suggest that several shared pathways are likely for MCC and other cancers, including immunosuppression, UV radiation, and genetics.
authors.affiliation: Cancer Council Queensland, Brisbane, Queensland, Australia. Electronic address: dannyyoulden@cancerqld.org.au.
authors.forename: Danny R
authors.initials: DR
authors.lastname: Youlden
authors.affiliation: Cancer Council Queensland, Brisbane, Queensland, Australia; Griffith Health Institute, Griffith University, Gold Coast, Queensland, Australia; School of Public Health and Social Work, Queensland University of Technology, Brisbane, Queensland, Australia.
authors.forename: Philippa H
authors.initials: PH
authors.lastname: Youl
authors.affiliation: Dermatology Research Centre, The University of Queensland, School of Medicine, Translational Research Institute, Princess Alexandra Hospital, Brisbane, Queensland, Australia.
authors.forename: H
authors.initials: H
authors.lastname: Peter Soyer
authors.affiliation: School of Public Health, Curtin University, Perth, Western Australia, Australia.
authors.forename: Lin
authors.initials: L
authors.lastname: Fritschi
authors.affiliation: Cancer Council Queensland, Brisbane, Queensland, Australia; Griffith Health Institute, Griffith University, Gold Coast, Queensland, Australia; School of Public Health and Social Work, Queensland University of Technology, Brisbane, Queensland, Australia.
authors.forename: Peter D
authors.initials: PD
authors.lastname: Baade
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001315:Australia / Q000453:epidemiology; D015266:Carcinoma, Merkel Cell / Q000453:epidemiology*; D015331:Cohort Studies; D015897:Comorbidity; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009378:Neoplasms, Multiple Primary / Q000453:epidemiology*; D011793:Queensland / Q000453:epidemiology; D012042:Registries; D012189:Retrospective Studies; D012307:Risk Factors; D012878:Skin Neoplasms / Q000453:epidemiology*