Incidence of metachronous second primary cancers in Osaka, Japan: Update of analyses using population‐based cancer registry data

Abstract

Cancer survivors are at excess risk of developing second primary cancers, but the precise level of risk in Japanese patients is not known. To investigate the risk of survivors developing second primary cancers, we conducted a retrospective cohort study using data from the Osaka Cancer Registry. The study subjects comprised all reported patients aged 0-79 years who were first diagnosed with cancer between 1985 and 2004 in Osaka and who survived for at least 3 months, followed-up through to December 2005. A metachronous second primary cancer was defined as any invasive second cancer that was diagnosed between 3 months and 10 years after the first cancer diagnosis. The main outcome measures were incidence rates per 100 000 person-years, cumulative risk and standardized incidence ratios (SIR) of second primary cancer. Metachronous second primary cancers developed in 13 385 of 355 966 survivors (3.8%) after a median follow-up of 2.5 years. Sex-specific incidence rates of metachronous second primary cancer per 100 000 person-years increased with age, and were higher among men than women (except for the 0-49 years age group), but these rates did not differ over the study period. The 10-year cumulative risk was estimated as 13.0% for those who first developed cancer at 60-69 years of age (16.2% for men, 8.6% for women). The SIR among those with first cancer diagnosed at 0-39 and 40-49 years of age were 2.13 and 1.52, respectively, in both sexes, whereas the SIR among cancers of the mouth/pharynx, esophagus and larynx were much higher than one as for site relationships. We showed that cancer survivors in Osaka, Japan, were at higher risk of second primary cancers compared with the general population. Our findings indicate that second primary cancers should be considered as a commonly encountered major medical problem. Further investigations are required to advance our understanding to enable the development of effective measures against multiple primary cancers. (Cancer Sci 2012; 103: 1111-1120 A pproximately 50% of men and 40% of women will develop a cancer during their lifetime,(1) and half of all cancer patients in Japan will survive for at least 5 years.(2)Because of the longer survival times for several forms of cancer and the aging of the population, it is estimated that 5-10% of all cancer patients develop a further, independent primary cancer. (3,4) A better understanding of multiple primary cancers should yield greater insights into the shared etiological factors and basic mechanisms of carcinogenesis and could thus provide a more sound basis for the management of cancer patients, including the development of protective measures. In a previous study using data from the Osaka Cancer Registry (2000 Census population; 8.8 million), one of the largest population-based cancer registries in the world, we reported that 2.0% of cancer patients developed metachronous second primary cancer between 1966 and 1986. (4) We also calculated the 10-year cumulative risk for metachronous second primaries to be approximately 10% ...

Cáncer sincrónico y metacrónico detectado con PET/CT en población oncológica

“…Ya que la frecuencia de ocurrencia de neoplasias depende entre otras cosas de la población en estudio, parece lógico separar dentro de la población oncológica a aquellos pacientes que debutan con un cáncer y que se realizan un PET de etapificación, de aquellos con una malignidad ya tratada y en seguimiento, ya que muchos de estos últimos han recibido terapias que pueden predisponer la aparición de nuevas neoplasias [10][11][12] . En los pacientes con cáncer de reciente diagnóstico, la ocurrencia de neoplasias sincrónicas insospechadas reportada en la literatura fluctúa entre 1,7 y 17,6 % de los individuos que se realizan Cáncer sincrónico y metacrónico detectado con PET/CT -D. Ladrón de Guevara et al un PET/CT corporal 7,8,[13][14][15][16][17] .…”

“…Se definió cáncer metacrónico a una segunda neoplasia maligna diagnosticada entre 6 meses y 10 años después del diagnóstico del primer cáncer 2,3,10 .…”

Synchronous double primary cancer of the lung and nasal vestibule: A case report and literature review

“…A study in Japan reported that the esophagus, ovary, larynx, pharynx and mouth were the most frequent sites for developing a second primary cancer (21). In Queensland, Australia, from 1997 to 2001, second primary cancers of the head and neck were frequent, whereas those of the esophagus and ovary were not as common (22).…”

“…The incidence of second cancers has increased (21)(22)(23). A study on data from the European Cancer Registry reported an overall incidence of double primary cancer of 6.3% (range, 0.4-12.9%) (24); Utada et al reported that the proportion of patients with a second primary tumor during the follow-up period was 8.1% (median, 1.8 years; mean, 4.3 years) (25).…”

“…Filali et al reported variable proportions of double primary cancer, ranging between 6.1 and 10.5% (26). Furthermore, the risk of second primary cancer among cancer patient was higher compared with the risk of cancer in the general population (21)(22)(27)(28). For example, among second primary cancers, 19.0% were diagnosed within 3 months after the diagnosis of the first primary cancer (25).…”