Increased Risk of Second Primary Malignancies in Patients with Gynecological Cancer: A Swedish record-linkage study

Bergfeldt, Kjell; Einhorn, Stefan; Rosendahl, Ingvar; Hall, Per

doi:10.3109/02841869509127185

Cited by 50 publications

(48 citation statements)

References 26 publications

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“…As a matter of fact, increased colon cancer risk has been observed after pelvic irradiation for female genital benign and malignant conditions, or cancers of the testis. 4,20,21 Our data did not show a significant increase of rectal cancer risk in the radiation group, although the rectum is heavily irradiated during radiotherapy for the prostate. The limited statistical power of the study may partially account for this result.…”

Section: Discussionmentioning

confidence: 66%

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Increased risk of colon cancer after external radiation therapy for prostate cancer

Rapiti

Fioretta

Verkooijen

et al. 2008

Intl Journal of Cancer

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Radiotherapy can induce second cancers. Controversies still exist regarding the risk of second malignancies after irradiation for prostate cancer. We evaluated the risk of developing colon and rectum cancers after prostate cancer in irradiated and nonirradiated patients. Using data from the population-based Geneva cancer registry, we included in the study all men with prostate cancer diagnosed between 1980 and 1998 who survived at least 5 years after diagnosis. Of the 1,134 patients, 264 were treated with external radiotherapy. Patients were followed for occurrence of colorectal cancer up to 31 December, 2003. We calculated standardized incidence ratios (SIR) using incidence rates for the general population to obtain the expected cancer incidence. The cohort yielded to 3,798 person-years. At the end of follow-up 19 patients had developed a colorectal cancer. Among irradiated patients the SIR for colorectal cancer was 3.4 (95% confidence intervals [CI] 1.7-6.0). Compared to the general population, the risk was significantly higher for colon cancer (SIR 5 4.0, 95% CI: 1.8-7.6), but not for rectal cancer (SIR 5 2.0, 95% CI: 0.2-7.2). The risk of colon cancer was increased in the period of 5-9 years after diagnosis (SIR 5 4.7, 95% CI: 2.0-9.2). The overall SIR of secondary cancer in patients treated with radiotherapy was 1.35 (p 5 0.056). Nonirradiated patients did not have any increased risk of rectal or colon cancer. This study shows a significant increase of colon but not rectum cancer after radiotherapy for prostate cancer. The risk of second cancer after irradiation, although probably small, needs nevertheless to be carefully monitored.

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Section: Discussionmentioning

confidence: 66%

“…[1][2][3][4][5][6] Controversy still exists, however, on the risk of colon and rectal cancer after irradiation of the prostate. Some authors found an increased risk of developing colon and rectal cancer 7,8 or rectal cancer only, 9,10 whereas others concluded there was no association between irradiation of the prostate and secondary colorectal cancer.…”

mentioning

confidence: 99%

Increased risk of colon cancer after external radiation therapy for prostate cancer

Rapiti

Fioretta

Verkooijen

et al. 2008

Intl Journal of Cancer

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“…The incidence of metachronous MPC is also influenced by the screening effect, because at least some parts of metachronous MPCs, which would also be detected during the follow-up period, would be detected as synchronous MPC during the first admission or would be detected at an early point in time during the follow-up period. As a result of the screening effect, the risk of MPC among cancer patients is often overestimated when it is compared with cancer incidence rates of the general population (23,26,27). When they are compared with an internal reference within the cohort, the overestimation of the risk of MPC due to the screening effect can be improved, because the patients in the cohort will receive a similar quality and quantity of physical check-ups during their follow-up periods.…”

Section: Discussionmentioning

confidence: 99%

Epidemiological Analysis of Site Relationships of Synchronous and Metachronous Multiple Primary Cancers in the National Cancer Center, Japan, 1962-1996

Kaneko

Yamaguchi

1999

Japanese Journal of Clinical Oncology

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Background: Multiple primary cancer (MPC) has been recognized as a problem commonly encountered in routine medical practice. A study of MPC is necessary not only to provide insights into the etiology of cancer, but also to provide information for effective medical care by clinical oncologists. Methods: A cohort of 49751 cancer patients who were admitted to the National Cancer Center Hospital between 1962 and 1996 was used to study the site relationship of MPC. Logistic and Poisson regression analyses using an internal reference group within the cohort were applied for the calculation of the prevalence odds ratio (POR) for site relationships of synchronous MPC and the incidence rate ratio (IRR) for those of metachronous MPC. Results: Three site combinations with elevated risks for both synchronous and metachronous MPCs, eight with elevated risk for synchronous MPC, five with elevated risk for metachronous MPC and six with decreased risk for synchronous MPC were identified with statistical significance. Among them, the increased risk of metachronous stomach cancer following lymphoma and myeoloma (POR = 1.0 and 1.1, P> 0.05; IRR = 2.5, P < 0.05) and the inverse site-correlation of synchronous MPC between [trachea, bronchus and lung] and other sites of the upper aerodigestive tract [lip, oral cavity and pharynx] (POR = 0.5 and 0.3, P < 0.05) and esophagus (POR =0.7 and 0.3, P < 0.05) have not been reported previously. Conclusions:Our results suggest that interventions for lymphoma and myeloma might affect the development of subsequent stomach cancer and additional etiological factors other than tobacco smoking are associated with the development of cancer in the upper aerodigestive tract.

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“…For example, estimates of the relative risk for CRC in women with a history of ovarian cancer have ranged from 1.3 to 3.67. [2][3][4][5][6] Among the few studies that examined the risk of CRC in women with a history of uterine and cervical cancer, results were even less conclusive. 2,4,7 These studies using cancer registries all lacked a control group and had a limited ability to adjust for potential confounding variables such as nonsteroidal anti-inflammatory drug (NSAID) therapy, diabetes mellitus, body mass index (BMI), hormonal replacement therapy (HRT), and family history of CRC.…”

mentioning

confidence: 99%

“…[2][3][4][5][6] Among the few studies that examined the risk of CRC in women with a history of uterine and cervical cancer, results were even less conclusive. 2,4,7 These studies using cancer registries all lacked a control group and had a limited ability to adjust for potential confounding variables such as nonsteroidal anti-inflammatory drug (NSAID) therapy, diabetes mellitus, body mass index (BMI), hormonal replacement therapy (HRT), and family history of CRC. [8][9][10][11][12] In addition, it is unclear whether the positive association between gynecologic cancers and CRC in some of the earlier studies was influenced by a detection bias.…”

mentioning

confidence: 99%

Risk of Colorectal Cancer in Women With a Prior Diagnosis of Gynecologic Malignancy

Srinivasan

Yang²,

Rubin

et al. 2007

Journal of Clinical Gastroenterology

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Increased Risk of Second Primary Malignancies in Patients with Gynecological Cancer: A Swedish record-linkage study

Cited by 50 publications

References 26 publications

Increased risk of colon cancer after external radiation therapy for prostate cancer

Increased risk of colon cancer after external radiation therapy for prostate cancer

Epidemiological Analysis of Site Relationships of Synchronous and Metachronous Multiple Primary Cancers in the National Cancer Center, Japan, 1962-1996

Risk of Colorectal Cancer in Women With a Prior Diagnosis of Gynecologic Malignancy

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