title: Risk of second primary cancer after a first potentially-human papillomavirus-related cancer: A population-based study.
abstract: Human papillomaviruses (HPV) are involved in the development of anogenital and head and neck cancers. The purpose of this study was to assess the risk of developing a second primary cancer (SPC) after a first potentially-HPV-related cancer, and to analyze the sites where SPCs most frequently occurred in these patients. All patients with a first cancer diagnosed between 1989 and 2004, as recorded by 10 French cancer registries, were followed up until December 31, 2007. Only invasive potentially-HPV-related cancers (namely, cervical, vagina, vulva, anal canal, penile, oropharynx, tongue and tonsil) were included. Standardized Incidence Ratios (SIRs) were calculated to assess the risk of SPC. A multivariate Poisson regression model was used to model SIRs separately by gender, adjusted for the characteristics of the first cancer. 10,127 patients presented a first potentially-HPV-related cancer. The overall SIR was 2.48 (95% CI, 2.34-2.63). The SIR was 3.59 (95% CI, 3.33-3.86) and 1.61 (95% CI, 1.46-1.78) in men and women respectively. The relative risk of potentially-HPV-related SPC was high among these patients (SIR=13.74; 95% CI, 8.80-20.45 and 6.78; 95% CI, 4.61-9.63 for men and women, respectively). Women diagnosed in the most recent period (2000-2004) showed a 40% increase of their relative risk of SPC as compared with women diagnosed between 1989 and 1994 (ratio of SIRs=1.40; 95% CI, 1.06-1.85). HPV cancer survivors face an increased risk of SPC, especially second cancer. Clinicians may consider this increased risk of developing HPV-related SPC during follow-up to improve subsequent cancer prevention in these patients.
authors.affiliation: Registre des tumeurs du Doubs et du Territoire de Belfort, University Hospital Besançon, F-25000 Besançon, France. Electronic address: florent.neumann@hotmail.fr.
authors.forename: Florent
authors.initials: F
authors.lastname: Neumann
authors.affiliation: Registre des cancers du Bas-Rhin, Laboratoire d'Épidémiologie et de Santé Publique, EA3430, FMTS, University of Strasbourg, F-67085 Strasbourg, France; Service de santé publique, University Hospital of Strasbourg, F-67091 Strasbourg, France; Francim: Réseau français des registres des cancers, F-31073 Toulouse, France.
authors.forename: Jérémie
authors.initials: J
authors.lastname: Jégu
authors.affiliation: University of Franche-Comte, EA 3181, FED4234, LabExLipSTIC ANR-11-LABX-0021-FED4234, CIC-1431 F-25000 Besançon, France; University Hospital Besançon, F-25000 Besançon, France.
authors.forename: Christiane
authors.initials: C
authors.lastname: Mougin
authors.affiliation: University of Franche-Comte, EA 3181, FED4234, LabExLipSTIC ANR-11-LABX-0021-FED4234, CIC-1431 F-25000 Besançon, France; University Hospital Besançon, F-25000 Besançon, France.
authors.forename: Jean-Luc
authors.initials: JL
authors.lastname: Prétet
authors.affiliation: Registre général des tumeurs du Calvados, Cancers & Préventions - U 1086 Inserm, Centre François Baclesse, F-14076, Caen 05, France; Francim: Réseau français des registres des cancers, F-31073 Toulouse, France.
authors.forename: Anne-Valérie
authors.initials: AV
authors.lastname: Guizard
authors.affiliation: Registre du cancer de la Somme, Service Épidémiologie Hygiène et Santé Publique, University Hospital Nord, F-80054 Amiens, France; Francim: Réseau français des registres des cancers, F-31073 Toulouse, France.
authors.forename: Bénédicte
authors.initials: B
authors.lastname: Lapôtre-Ledoux
authors.affiliation: Registre des cancers de la Manche, Hospital of Cotentin, F-50102 Cherbourg-Octeville, France; Francim: Réseau français des registres des cancers, F-31073 Toulouse, France.
authors.forename: Simona
authors.initials: S
authors.lastname: Bara
authors.affiliation: Registre des tumeurs digestives du Calvados, Cancers & Préventions - U 1086 Inserm, Centre François Baclesse, BP 5026, F-14076, Caen 05, France; Francim: Réseau français des registres des cancers, F-31073 Toulouse, France.
authors.forename: Véronique
authors.initials: V
authors.lastname: Bouvier
authors.affiliation: Registre des cancers de l'Isère, University Hospital Grenoble, BP 217, F-38043, Grenoble 9, France; Francim: Réseau français des registres des cancers, F-31073 Toulouse, France.
authors.forename: Marc
authors.initials: M
authors.lastname: Colonna
authors.affiliation: Registre des hémopathies malignes de Basse-Normandie, Unité Fonctionnelle Hospitalo-Universitaire n°0350, University Hospital Caen, F-14033 Caen, France; Francim: Réseau français des registres des cancers, F-31073 Toulouse, France.
authors.forename: Xavier
authors.initials: X
authors.lastname: Troussard
authors.affiliation: Registre des tumeurs de l'Hérault, Centre de Recherche, F-34298, Montpellier 5, France; Francim: Réseau français des registres des cancers, F-31073 Toulouse, France.
authors.forename: Brigitte
authors.initials: B
authors.lastname: Trétarre
authors.affiliation: Registre des cancers du Tarn, BP 37, F-81001 Albi, France; Francim: Réseau français des registres des cancers, F-31073 Toulouse, France.
authors.forename: Pascale
authors.initials: P
authors.lastname: Grosclaude
authors.affiliation: Registre des cancers du Bas-Rhin, Laboratoire d'Épidémiologie et de Santé Publique, EA3430, FMTS, University of Strasbourg, F-67085 Strasbourg, France; Service de santé publique, University Hospital of Strasbourg, F-67091 Strasbourg, France; Francim: Réseau français des registres des cancers, F-31073 Toulouse, France.
authors.forename: Michel
authors.initials: M
authors.lastname: Velten
authors.affiliation: Registre des tumeurs du Doubs et du Territoire de Belfort, University Hospital Besançon, F-25000 Besançon, France; University of Franche-Comte, EA 3181, FED4234, LabExLipSTIC ANR-11-LABX-0021-FED4234, CIC-1431 F-25000 Besançon, France; Francim: Réseau français des registres des cancers, F-31073 Toulouse, France.
authors.forename: Anne-Sophie
authors.initials: AS
authors.lastname: Woronoff
mesh_terms: D005260:Female; D005602:France; D006258:Head and Neck Neoplasms / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D016609:Neoplasms, Second Primary / Q000453:epidemiology*; D027383:Papillomaviridae / Q000302:isolation & purification; D030361:Papillomavirus Infections / Q000150:complications*; D011159:Population Surveillance / Q000379:methods*; D012042:Registries; D012189:Retrospective Studies; D012307:Risk Factors; D014565:Urogenital Neoplasms / Q000453:epidemiology
keywords: Human papillomavirus; Neoplasms, second primary; Registries; Risk assessment