title: Risk of Second Primary Cancers in Multiple Myeloma Survivors in German and Swedish Cancer Registries.
abstract: We aimed at investigating the distribution and risk of second primary cancers (SPCs) in multiple myeloma (MM) survivors in Germany and Sweden to provide etiological understanding of SPCs and insight into their incidence rates and recording practices. MM patients diagnosed in 1997-2010 at age ≥15 years were selected from the Swedish (nationwide) and 12 German cancer registries. Standardized incidence ratios (SIRs) were used to assess risk of a specific SPC compared to risk of the same first cancer in the corresponding background population. Among 18,735 survivors of first MM in Germany and 7,560 in Sweden, overall 752 and 349 SPCs were recorded, respectively. Significantly elevated SIRs of specific SPCs were observed for acute myeloid leukemia (AML; SIR = 4.9) in Germany and for kidney cancer (2.3), AML (2.3) and nervous system cancer (1.9) in Sweden. Elevated risk for AML was more pronounced in the earlier diagnosis period compared to the later, i.e., 9.7 (4.2-19) for 1997-2003 period versus 3.5 (1.5-6.9) for 2004-2010 in Germany; 3.8 (1.4-8.3) for 1997-2003 versus 2.2 (0.3-7.8) for 2004-2010 in Sweden. We found elevated risk for AML for overall, early diagnosis periods and longer follow-up times in both populations, suggesting possible side effects of treatment for MM patients.
authors.affiliation: Division of Molecular Genetic Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany.|Institute of Occupational Diseases Prevention, Zhejiang Academy of Medical Sciences, Hangzhou, China.
authors.forename: Tianhui
authors.initials: T
authors.lastname: Chen
authors.affiliation: Division of Molecular Genetic Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany.
authors.forename: Mahdi
authors.initials: M
authors.lastname: Fallah
authors.affiliation: Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany.|Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg, Germany.|German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany.
authors.forename: Hermann
authors.initials: H
authors.lastname: Brenner
authors.affiliation: Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany.
authors.forename: Lina
authors.initials: L
authors.lastname: Jansen
authors.affiliation: Department of Internal Medicine V, University Clinic of Heidelberg, Heidelberg, Germany.
authors.forename: Elias K
authors.initials: EK
authors.lastname: Mai
authors.affiliation: Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany.
authors.forename: Felipe A
authors.initials: FA
authors.lastname: Castro
authors.affiliation: Institute of Cancer Epidemiology, University of Lübeck, Lübeck, Germany.
authors.forename: Alexander
authors.initials: A
authors.lastname: Katalinic
authors.affiliation: Cancer Registry of Rhineland-Palatinate, Institute for Medical Biostatistics, Epidemiology and Informatics, University Medical Center, Johannes Gutenberg University, Mainz, Germany.
authors.forename: Katharina
authors.initials: K
authors.lastname: Emrich
authors.affiliation: Saarland Cancer Registry, Saarbrücken, Germany.
authors.forename: Bernd
authors.initials: B
authors.lastname: Holleczek
authors.affiliation: Bayern Cancer Registry, Munich, Germany.
authors.forename: Karla
authors.initials: K
authors.lastname: Geiss
authors.affiliation: Cancer Registry of Bremen, Leibniz-Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany.
authors.forename: Andrea
authors.initials: A
authors.lastname: Eberle
authors.affiliation: Center for Primary Health Care Research, Lund University, Malmö, Sweden.|Stanford Prevention Research Center, Stanford University School of Medicine, Stanford, California 94305-5705, USA.
authors.forename: Kristina
authors.initials: K
authors.lastname: Sundquist
authors.affiliation: Division of Molecular Genetic Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany.|Center for Primary Health Care Research, Lund University, Malmö, Sweden.
authors.forename: Kari
authors.initials: K
authors.lastname: Hemminki
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use; D042241:Early Diagnosis; D005260:Female; D005858:Germany; D006801:Humans; D007680:Kidney Neoplasms / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D015470:Leukemia, Myeloid, Acute / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D016609:Neoplasms, Second Primary / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D009423:Nervous System Neoplasms / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D012042:Registries; D012307:Risk Factors; D017741:Survivors / Q000706:statistics & numerical data; D013548:Sweden; D013997:Time Factors
chemical_list: D000970:Antineoplastic Agents