Risk factors for the development of second primary tumors among men after laryngeal and hypopharyngeal carcinoma

Abstract

BACKGROUND Second primary tumors (SPT) constitute a major threat to the survival of patients with laryngeal carcinoma. However, to the authors' knowledge little is known regarding the risk factors for developing SPTs or about the strategy to be followed to avoid them. METHODS Eight hundred seventy‐six male patients with laryngeal/hypopharyngeal carcinoma enrolled in a population‐based, case–control study in 5 centers from South Europe during 1979–1982 were followed up to ascertain the occurrence of SPTs. Standardized incidence ratios were calculated to estimate the risk of SPT occurring in the cohort. Cox proportional hazard models were fitted to estimate the hazard ratio for development of SPTs in relation to use of tobacco smoking, alcohol consumption, and dietary habits before the first primary tumor. RESULTS One hundred forty‐five patients developed an SPT with an annual average rate of 2.1%. An excess risk of developing an SPT of the tongue, mouth, esophagus, and lung was observed. No elevated risks of SPTs were observed in other organs. Alcohol consumption strongly increased the risk of developing an SPT of the upper aerodigestive tract (UADT). Heavy cumulative cigarette smoking increased the risk of developing a lung SPT. A protective effect of high intake of citrus fruit was noticed for SPT in the lung, whereas high butter intake was associated with an increased risk for SPT of the UADT. CONCLUSIONS Continuous medical surveillance was essential in the UADT and lung to reduce the risk from an SPT after initial laryngeal/hypopahryngeal carcinoma. Alcohol consumption before the first primary tumor was a risk factor for SPT of the UADT. The study suggested a protective role of citrus fruits in the development of a lung SPT. Cancer 2005. © 2005 American Cancer Society.

Alcohol Drinking and Second Primary Cancer Risk in Patients with Upper Aerodigestive Tract Cancers: A Systematic Review and Meta-analysis of Observational Studies

“…Seven studies, 4 cohort (12, 13, 21, 22) and 3 case-control studies (23)(24)(25), investigated UADT and lung second primary cancers combined. Six cohort studies provided risk estimates for second primary cancers for all sites as defined by the authors (11)(12)(13)(26)(27)(28). Most studies examined indistinctly synchronous or metachronous second primary cancers (11,15,18,23,26) or did not provide information on the delay between the two diagnoses (12, 13, 16, 17, 19-21, 25, 27, 28).…”

“…In the case of duplicate information, we used the publication providing the most adjusted risk estimation, up to date and complete data about second primary cancer sites, and defined alcohol consumption. Twenty potentially relevant full-text publications were identified (10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29). We excluded one duplicate publication, as confirmed by the authors (10).…”

Hypermethylation, risk factors, clinical characteristics, and survival in 235 patients with laryngeal and hypopharyngeal cancers

“…13 In brief, these criteria emphasized that an SPT must be clearly distinct from the first tumor in terms of location but not necessarily in terms of the time of appearance. Nonmelanoma skin carcinoma (ICD9 code 173) was not considered an SPT.…”

“…Results concerning patient survival and the occurrence of SPTs according to demographic and lifestyle factors recently have been published. 3,13 Surgical paraffin-embedded tissue (PET) sections were collected for the current study from 235 patients who had complete follow-up information available. The patients were comprised of 155 men and 12 women from the city of Turin, Italy, and 67 men and 1 woman from the province of Navarra, Spain.…”

What is the most cost-effective strategy to screen for second primary colorectal cancers in male cancer survivors in Korea?

“…ity or unhealthy behavior such as smoking, alcohol and obesity, cancer survivors are at increased risk for SPCs, not only at the original site but at other sites as well [3,4] . Recent studies have shown that the age-standardized incidence rate was 2.3 times higher for an SPC than for a first cancer in the Korean general male population [5] .…”