title: Risk of second primary malignancies among cancer survivors in the United States, 1992 through 2008.
abstract: In the current study, the authors attempted to describe the incidence, most common sites, and mortality of second primary malignancies among survivors of common cancers.
  
  
  
  The authors identified patients aged ≥18 years who were diagnosed with a primary malignancy from the 10 most common cancer sites (prostate, breast, lung, colon, rectum, bladder, uterus, kidney, melanoma, and non-Hodgkin lymphoma) between 1992 and 2008 from Surveillance, Epidemiology, and End Results data. Factors associated with the incidence of second primary malignancies were explored using bivariable and multivariable models, and mortality attributable to first and second primary malignancies was examined.
  
  
  
  A cohort of 2,116,163 patients was identified, 170,865 of whom (8.1%) developed a second primary malignancy. Survivors of bladder cancer had the highest risk of developing a second cancer. In a multivariable model controlling for age, race, tumor grade, stage of disease, marital status, educational level, and income, a history of non-Hodgkin lymphoma (hazard ratios of 2.70 and 2.88, respectively, for men and women) and bladder cancer (hazard ratios of 1.88 and 1.66, respectively, for men and women) predicted the highest risk of developing a second cancer. For patients with 2 incident cancers, 13% died of their initial cancer, but greater than one-half (55%) died of their second primary malignancy. Lung cancer was the cause of death in 12% of patients with 2 incident cancers.
  
  
  
  Nearly 1 in 12 patients diagnosed with a common cancer developed a second malignancy, the most common of which was lung cancer. Greater than one-half of patients with 2 incident cancers died of their secondary malignancy. The findings from the current study may inform care strategies among cancer survivors. Cancer 2016;122:3075-3086. © 2016 American Cancer Society.
authors.affiliation: Department of Urology, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, California.
authors.forename: Nicholas
authors.initials: N
authors.lastname: Donin
authors.affiliation: Department of Urology, Emory University, Atlanta, Georgia.|Department of Urology, Atlanta Veterans Administration Medical Center, Decatur, Georgia.
authors.forename: Christopher
authors.initials: C
authors.lastname: Filson
authors.affiliation: Department of Urology, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, California.|Jonsson Comprehensive Cancer Center, University of California at Los Angeles, Los Angeles, California.|Division of Hematology and Oncology, Department of Medicine, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, California.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Drakaki
authors.affiliation: Department of Urology, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, California.
authors.forename: Hung-Jui
authors.initials: HJ
authors.lastname: Tan
authors.affiliation: Department of Epidemiology, Fielding School of Public Health, University of California at Los Angeles, Los Angeles, California.
authors.forename: Alex
authors.initials: A
authors.lastname: Castillo
authors.affiliation: Department of Urology, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, California.
authors.forename: Lorna
authors.initials: L
authors.lastname: Kwan
authors.affiliation: Department of Urology, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, California.|Jonsson Comprehensive Cancer Center, University of California at Los Angeles, Los Angeles, California.|Department of Health Policy and Management, Fielding School of Public Health, University of California at Los Angeles, Los Angeles, California.
authors.forename: Mark
authors.initials: M
authors.lastname: Litwin
authors.affiliation: Department of Urology, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, California. KChamie@mednet.ucla.edu.|Jonsson Comprehensive Cancer Center, University of California at Los Angeles, Los Angeles, California. KChamie@mednet.ucla.edu.
authors.forename: Karim
authors.initials: K
authors.lastname: Chamie
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009369:Neoplasms / Q000628:therapy*; D016609:Neoplasms, Second Primary / Q000453:epidemiology* / Q000401:mortality*; D011379:Prognosis; D012307:Risk Factors; D018426:SEER Program; D015996:Survival Rate; D017741:Survivors / Q000706:statistics & numerical data*; D013997:Time Factors; D014481:United States / Q000453:epidemiology; D055815:Young Adult
keywords: Surveillance, Epidemiology, and End Results (SEER) program; epidemiology; screening; second primary neoplasms; survivors