title: Second Primary Lung Cancer After Head and Neck Cancer: Implications for Screening Computed Tomography.
abstract: BACKGROUND
  Recent guidelines recommend chest computed tomography (CT) for smokers based on studies of individuals aged 55 to 74 years with 30-pack year smoking to detect lung cancers. Some have postulated that a prior diagnosis of head and neck cancer (HNC) should also warrant lung cancer screening with CT, but no studies have demonstrated benefit in this population. Our goal was to compare survival of HNC patients with second primary lung cancers (SPLCs) with survival of lung cancer-only patients to determine if detecting early stage lung cancer in those with prior HNC could lead to similar survival benefits.
  
  
  METHODS
  Survival estimates for patients with early stage SPLC diagnosed between ages 55 and 74 at least 1 year after HNC diagnosis were compared with patients with early stage lung cancer and no other cancers.
  
  
  RESULTS
  Median survival of patients with lung cancer only was 38 months. Median survival after SPLC was 22 months. History of head and neck cancer predicted poorer survival after lung cancer diagnosis, P<.0001.
  
  
  CONCLUSIONS
  Survival outcomes after early lung cancer are worse after HNC. This finding diminishes the effectiveness of chest CT as a screening modality for HNC survivors, and further study should be undertaken prior to its routine use.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University of Iowa, Iowa City, Iowa, USA nitin-pagedar@uiowa.edu.
authors.forename: Nitin A
authors.initials: NA
authors.lastname: Pagedar
authors.affiliation: Department of Otolaryngology, Vanderbilt University, Nashville, Tennessee, USA.
authors.forename: Asitha
authors.initials: A
authors.lastname: Jayawardena
authors.affiliation: Department of Epidemiology, University of Iowa, Iowa City, Iowa, USA.
authors.forename: Mary E
authors.initials: ME
authors.lastname: Charlton
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University of Iowa, Iowa City, Iowa, USA.
authors.forename: Henry T
authors.initials: HT
authors.lastname: Hoffman
mesh_terms: D000368:Aged; D055088:Early Detection of Cancer / Q000379:methods / Q000706:statistics & numerical data; D005260:Female; D006258:Head and Neck Neoplasms / Q000453:epidemiology / Q000473:pathology; D006801:Humans; D008175:Lung Neoplasms / Q000209:etiology / Q000401:mortality / Q000473:pathology; D008297:Male; D008403:Mass Screening / Q000379:methods; D008875:Middle Aged; D016609:Neoplasms, Second Primary / Q000209:etiology / Q000401:mortality / Q000473:pathology; D017063:Outcome Assessment, Health Care; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology; D016019:Survival Analysis; D014057:Tomography, X-Ray Computed / Q000379:methods; D014481:United States / Q000453:epidemiology
keywords: early detection of cancer; head and neck neoplasm; lung neoplasm; second primary neoplasms