Incidence of Second Primary Malignancies Following Colorectal Cancer

Lee, Yu Ting; Liu, Chia Jen; Hu, Yu; Teng, Chih‐Ching; Tzeng, Cheng Hwai; Yeh, Chiu Mei; Chen, Tzeng Ji; Lin, Jen Kou; Lin, Chun Chi; Lan, Yuan Tzu; Wang, Huann Sheng; Yang, Shung Haur; Jiang, Jeng Kai; Chen, Wei Shone; Lin, Tzu Chen; Chang, Shih Ching; Chen, Ming-Huang; Teng, Hao Wei; Liu, Jin Hwang; Yen, Chueh Chuan

doi:10.1097/md.0000000000001079

Cited by 30 publications

(34 citation statements)

References 29 publications

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“…The association between the risk of multiple PMs and the primary CRC subsite was reported previously in a study by Lee et al11 These authors showed that the risk of thyroid, prostate, ovary, and hematological system cancers increased in patients with colon cancer, whereas patients with rectal cancer showed an increased risk of bone and soft-tissue cancers and a decreased risk of liver and gallbladder cancers. The present study confirmed the difference between patients with colon cancer and rectal cancer, and identified a difference between patients with right-sided and left-sided colon cancer.…”

Section: Discussionsupporting

confidence: 70%

“…In an earlier study, old patients were found to be at higher risk than young patients 11. Age ≥70 years was even considered an independent predictor for second primary cancer.…”

Section: Discussionmentioning

confidence: 89%

“…The results of the current study indicated that CRC survivors have a 2% higher overall risk of developing SPMs than the general US population. Lee et al found a 13% higher risk for secondary primary cancer in CRC survivors in Taiwan 11. Although the reasons for the differences in relative risk are not clear, they may be attributed in part to the different populations included in the SEER and the Taiwanese cohort.…”

Section: Discussionmentioning

confidence: 99%

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Risk of subsequent primary malignancies among patients with prior colorectal cancer: a population-based cohort study

Jiao

et al. 2017

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BackgroundThe site-distribution pattern and relative risk of subsequent primary malignancies (SPMs) in colorectal cancer (CRC) patients remains to be determined.Materials and methodsA population-based cohort of 288,390 CRC patients diagnosed between 1973 and 2012 from the Surveillance, Epidemiology, and End Results database was retrospectively reviewed. Standardized incidence ratios were calculated to estimate the relative risk for SPMs.ResultsThe overall risk of SPMs increased in CRC patients (standardized incidence ratio 1.02) in the first 5 years after CRC diagnosis compared with that in the general population, and was negatively related to age at diagnosis. Risk increased significantly for cancers of the small intestine, ureter, colorectum, renal pelvis, endocrine system, and stomach, and decreased significantly for cancers of the gallbladder, liver, myeloma, and brain, as well as lymphoma. Patients with different prior CRC subsites showed specific sites at high risk of SPM. Prior right-sided colon cancer was associated with cancers of the small intestine, ureter, renal pelvis, thyroid, stomach, pancreas, and breast and prior left-sided colon cancer associated with secondary CRC, whereas rectal cancer was associated with cancers of the vagina, urinary bladder, and lung.ConclusionRisk of SPMs increases in CRC survivors, especially in the first 5 years after prior diagnosis. Intensive surveillance should be advocated among young patients, with specific attention to the small intestine, colorectum, renal pelvis, and ureter. The common sites at high risk of SPM originate from the embryonic endoderm. Genetic susceptibility may act as the main mechanism underlying the risk of multiple cancers.

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Section: Discussionsupporting

confidence: 70%

“…In an earlier study, old patients were found to be at higher risk than young patients 11. Age ≥70 years was even considered an independent predictor for second primary cancer.…”

Section: Discussionmentioning

confidence: 89%

Section: Discussionmentioning

confidence: 99%

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Risk of subsequent primary malignancies among patients with prior colorectal cancer: a population-based cohort study

Jiao

et al. 2017

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“…Previous studies have shown that risks of SPMs after CRC differed by location of first tumor [ 9 , 19 ]. In this work, our results also indicated that incidences of SPMs were different between CC and RC.…”

Section: Discussionmentioning

confidence: 99%

“…Owing to the expanding population of CRC survivors, one concerning issue is their long-term survival status, especially the risk of developing second primary malignancies (SPMs) [ 5 , 6 ]. Accumulated evidence suggested an elevated risk in patients with CRC for development of a variety of SPMs [ 7 – 9 ]. Intensive treatments for initial CRC, normal aging, and continuous exposed to carcinogens are considered to be major risk factors for the increased incidence of SPMs [ 10 – 12 ].…”

Section: Introductionmentioning

confidence: 99%

The Incidence Characteristics of Second Primary Malignancy after Diagnosis of Primary Colon and Rectal Cancer: A Population Based Study

et al. 2015

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BackgroundWith the expanding population of colorectal cancer (CRC) survivors in the United States, one concerning issue is the risk of developing second primary malignancies (SPMs) for these CRC survivors. The present study attempts to identify the incidence characteristics of SPMs after diagnosis of first primary colon cancer (CC) and rectal cancer (RC).Methods189,890 CC and 83,802 RC cases were identified from Surveillance, Epidemiology and End Results Program (SEER) database. We performed rate analysis on incidence trend of SPMs in both CC and RC. Expected incidence rates were stratified by age, race and stage, calendar year of first CRC diagnosis and latency period since first CRC diagnosis. The standardized incidence ratios (SIRs), measure for estimating risk of SPMs, were calculated for CC and RC respectively.ResultsThe trends of incidence of SPMs in both CC and RC were decreasing from 1992 to 2012. Both CC and RC survivors had higher risk of developing SPMs (SIRCC = 1.13; SIRRC = 1.05). For CC patients, the highest risks of SPM were cancers of small intestine (SIR = 4.03), colon (SIR = 1.87) and rectum (SIR = 1.80). For RC patients, the highest risks of SPMs were cancers of rectum (SIR = 2.88), small intestine (SIR = 2.16) and thyroid (SIR = 1.46). According to stratified analyses, we also identified incidence characteristics which were contributed to higher risk of developing SPMs, including the age between 20 and 40, American Indian/Alaska Native, localized stage, diagnosed at calendar year from 2002 to 2012 and the latency between 12 and 59 months.ConclusionsBoth CC and RC survivors remain at higher risk of developing SPMs. The identification of incidence characteristics of SPMs is extremely essential for continuous cancer surveillance among CRC survivors.

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Excessive risk of second primary cancers in young‐onset colorectal cancer survivors

Ding

et al. 2018

Cancer Medicine

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With an increasing trend of patients with young‐onset colorectal cancer (CRC), risks of second primary cancers (SPCs) among them become a concerning issue. We aimed to define the detailed risk and site‐distributed patterns of SPCs in young CRC individuals (age ≤50). A population‐based cohort were identified from the Surveillance, Epidemiology, and End Results database between 1973 and 2013. Standardized incidence ratios (SIRs) and absolute excess risk (AER) were calculated to assess the risk for SPCs compared with the general population. A total of 44,106 patients, including 3245 (7.4%) the young and 40,861 (92.6%) the old, developed 50,679 secondary malignancies subsequently. With increased age, the risk of secondary cancers gradually decreased. A significant 44% excess risk of SPCs was observed in the young (SIR = 1.44, AER = 34.23), while a slightly increased risk was noted in the old (SIR = 1.02, AER = 4.29). For young survivors, the small intestine (SIR = 8.49), bile ducts (SIR = 3.77), corpus, and uterus (SIR = 2.45) were the most common sites of SPCs. Significantly, excess SIRs in the young were persisted regardless of other factors. For the young, secondary cancer‐related deaths were responsible for 51.2% of overall deaths and secondary stomach, liver and bile, pancreas cancers were top three causes. An excessive risk of SPCs existed in young CRC survivors, and this trend was consistent among different subgroups. We hope our findings may inform future targeted screening strategies among young‐onset CRC survivors.

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Incidence of Second Primary Malignancies Following Colorectal Cancer

Cited by 30 publications

References 29 publications

Risk of subsequent primary malignancies among patients with prior colorectal cancer: a population-based cohort study

Risk of subsequent primary malignancies among patients with prior colorectal cancer: a population-based cohort study

The Incidence Characteristics of Second Primary Malignancy after Diagnosis of Primary Colon and Rectal Cancer: A Population Based Study

Excessive risk of second primary cancers in young‐onset colorectal cancer survivors

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