title: Incidence of Second Primary Malignancies Following Colorectal Cancer: A Distinct Pattern of Occurrence Between Colon and Rectal Cancers and Association of Co-Morbidity with Second Primary Malignancies in a Population-Based Cohort of 98,876 Patients in Taiwan.
abstract: The purpose of this study is to determine the features of second primary malignancies (SPMs) among patients with prior colorectal cancer (CRC) using a nationwide population-based dataset.Patients with CRC newly diagnosed between 1996 and 2011, and >1 year of follow-up were recruited from the Taiwan National Health Insurance database. Standardized incidence ratios (SIRs) of SPMs in patients with CRC were calculated.During the 16-year study period, 4259 SPMs developed among 98,876 CRC patients. The median duration of follow-up was 4.03 years. The SIR for all SPMs was 1.13 (95% confidence interval = 1.10-1.17). Compared with the general population, a higher incidence of thyroid, prostate, ovarian, and hematologic malignancies developed among patients with colon cancer, whereas the risk for bone and soft tissue cancers increased among patients with rectal cancer. The risk for breast, bladder, kidney, lung, and uterine cancers was significantly higher in patients with colon and rectal cancers than the general population. The risk for liver and biliary tract cancers declined in patients with rectal cancer. Based on multivariate analysis among patients with CRC, age ≥70 years, men, chronic obstructive pulmonary disease (COPD), cirrhosis, and dyslipidemia were independent predictors of an SPM.In conclusion, patients with CRC were at increased risk for a second cancer. The pattern of SPMs was distinct between patients with colon and rectal cancer. Age, men, COPD, cirrhosis, and dyslipidemia were independent risk factors for SPMs. Surveillance and education should be provided for survivors with respect to risk for SPMs.
authors.affiliation: From the Division of Hematology and Oncology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan (Y-TL, C-JL, C-HT, M-HC, H-WT, C-CY); National Yang-Ming University School of Medicine, Taipei, Taiwan (Y-TL, C-JL, , Y-WH, C-JT, C-HT, T-JC, J-KL, C-CL, Y-TL, H-SW, S-HY, J-KJ, W-SC, T-CL, S-CC, M-HC, H-WT, J-HL, C-CY); Department of Oncology, Taipei Veterans General Hospital, Taipei, Taiwan (Y-WH, J-HL); Division of Oncology and Hematology, Department of Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan (C-JT); Department of Family Medicine, Taipei Veterans General Hospital, Taipei, Taiwan (C-MY, T-JC); and Division of Colon and Rectal Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan (J-KL, C-CL, Y-TL, H-SW, S-HY, J-KJ, W-SC, T-CL, S-CC).
authors.forename: Yu-Ting
authors.initials: YT
authors.lastname: Lee
authors.forename: Chia-Jen
authors.initials: CJ
authors.lastname: Liu
authors.forename: Yu-Wen
authors.initials: YW
authors.lastname: Hu
authors.forename: Chung-Jen
authors.initials: CJ
authors.lastname: Teng
authors.forename: Cheng-Hwai
authors.initials: CH
authors.lastname: Tzeng
authors.forename: Chiu-Mei
authors.initials: CM
authors.lastname: Yeh
authors.forename: Tzeng-Ji
authors.initials: TJ
authors.lastname: Chen
authors.forename: Jen-Kou
authors.initials: JK
authors.lastname: Lin
authors.forename: Chun-Chi
authors.initials: CC
authors.lastname: Lin
authors.forename: Yuan-Tzu
authors.initials: YT
authors.lastname: Lan
authors.forename: Huann-Sheng
authors.initials: HS
authors.lastname: Wang
authors.forename: Shung-Haur
authors.initials: SH
authors.lastname: Yang
authors.forename: Jeng-Kai
authors.initials: JK
authors.lastname: Jiang
authors.forename: Wei-Shone
authors.initials: WS
authors.lastname: Chen
authors.forename: Tzu-Chen
authors.initials: TC
authors.lastname: Lin
authors.forename: Shih-Ching
authors.initials: SC
authors.lastname: Chang
authors.forename: Ming-Huang
authors.initials: MH
authors.lastname: Chen
authors.forename: Hao-Wei
authors.initials: HW
authors.lastname: Teng
authors.forename: Jin-Hwang
authors.initials: JH
authors.lastname: Liu
authors.forename: Chueh-Chuan
authors.initials: CC
authors.lastname: Yen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002277:Carcinoma / Q000453:epidemiology*; D003110:Colonic Neoplasms / Q000453:epidemiology*; D015897:Comorbidity; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016609:Neoplasms, Second Primary / Q000453:epidemiology*; D012004:Rectal Neoplasms / Q000453:epidemiology*; D012189:Retrospective Studies; D012307:Risk Factors; D013624:Taiwan / Q000453:epidemiology; D055815:Young Adult