Risk of extracolonic second primary cancers following a primary colorectal cancer: a systematic review and meta-analysis

Robertson, Dylan; Ng, Shu Kay; Baade, Peter D.; Lam, Alfred King‐Yin

doi:10.1007/s00384-022-04105-x

Cited by 9 publications

(5 citation statements)

References 51 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…We found higher kidney and bladder cancer cases numbers than expected. This is consistent with Robertson’s review, published in early 2022, which showed a pooled SIR equal to 1.19 (95% CI 1.06–1.33; p = 0.003) for bladder and to 1.50 (95% CI = 1.19–1.89; p = 0.0007) for kidney cancer [ 29 ]. Our results are close to these values, and the limited significance probably reflect the small sample size we observed.…”

Section: Discussionsupporting

confidence: 91%

“…This is consistent with other studies. Robertson and coworkers assessed a pooled SIR of 1.22 for stomach cancer (95% CI = 1.07–1.39; p = 0.003) in their review [ 29 ]. We found a higher magnitude of this association, despite the small sample size prevent us from a full comparison with Robertson’s data.…”

Section: Discussionmentioning

confidence: 99%

“…In the same way, smoke is unlikely to be related to this pattern of increase [ 21 ]. As noticed by Robertson et al, a possibility is that neoplasms such as ovary, stomach and bladder ones may be detected during the chest and abdominal computer tomography (CT) scan, contributing to a higher detection rate [ 29 ].…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Second Primary Cancers following Colorectal Cancer in Sicily, Italy

Collatuzzo

Ferrante

Ippolito

et al. 2022

Cancers

View full text Add to dashboard Cite

Background: Cancer survivors are at risk of developing second primary cancers (SPC). We investigated the risk of SPC in colorectal cancer (CRC) survivors in Sicily, Southern Italy. Methods: We analyzed data from the Eastern Sicily cancer registry covering 2.5 million people diagnosed and followed up between 2003 and 2017. We calculated the standardized incidence ratio (SIR) and 95% confidence interval (CI) of SPC overall and by cancer type, using the general Sicily population rates as reference. Results: A total of 19,040 cases of CRC and 1453 cases of SPC were included in the analysis. Mean age of occurrence of SPC was 68.1. The SIR for any SPC was 1.11 (95% CI 1.05–1.17); it was higher in women (1.18; 95% CI 1.08–1.29) than in men (1.07; 95% CI 0.97–1.14, p-value of difference 0.07). The SIR was increased for SPC from the ovary (SIR 2.01; 95% CI 1.33–2.95), kidney (SIR 2.00; 95% CI 1.54–2.56), endometrium (SIR 1.94; 95% CI 1.45–2.54), bladder (SIR 1.22, 95% CI 1.04–1.43) and stomach (1.29; 95% CI 0.98–1.66). The SIR for CRC as SPC was 0.84 (95% CI 0.70–1.01). No increased incidence was found for lung, prostate, breast, thyroid and liver cancer. The SIR for SPC overall and several cancers decreased with time of follow-up. Conclusions: In this population, CRC survivors have an 11% higher risk of developing a SPC than the general population, particularly cancers of the ovary, kidney, endometrium, bladder and stomach. Follow-up for SPC is required, especially during the first 5 years from CRC diagnosis.

show abstract

Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Second Primary Cancers following Colorectal Cancer in Sicily, Italy

Collatuzzo

Ferrante

Ippolito

et al. 2022

Cancers

View full text Add to dashboard Cite

show abstract

“…We analyzed the incidence of SPC among CRC survivors using large epidemiological cancer registry data covering over a third of the German adult population. Similar to previous reports from other national cancer registries, we found an elevated risk of a second cancer after CRC, particularly in the digestive system, respiratory tract, urinary system and prostate in males, female reproductive organs 15,[26][27][28][29] as well as second primary CRC. 17,27 This risk is pronounced in survivors <65 years of age, as previously observed.…”

Section: Discussionsupporting

confidence: 90%

Second primary cancer among 217702 colorectal cancer survivors: An analysis of national German cancer registry data

Liang

Tseng

Tanaka

et al. 2023

Intl Journal of Cancer

View full text Add to dashboard Cite

With improvements in survival after colorectal cancer (CRC), more survivors are at risk of developing a second cancer, particularly in younger populations where CRC incidence is increasing. We estimated the incidence of second primary cancer (SPC) in CRC survivors and its potential risk factors. We identified CRC cases diagnosed between 1990 and 2011 and SPCs until 2013 from nine German cancer registries. Standardized incidence ratios (SIR) and absolute excess risk (AER) per 10 000 person‐years were calculated and were stratified by index site: colon cancer (CC) and rectal cancer (RC), age and sex. Cox regression assessed potential SPC risk factors, including primary tumor‐related therapy considering death as a competing risk. We included 217 202 primary CRC cases. SPC occurred in 18 751 CRC survivors (8.6%; median age: 69 years). Risk of cancer was significantly higher in CRC survivors than in the general population (SIR males 1.14, 95% confidence interval [CI] 1.12‐1.17, AER = 24.7; SIR females 1.20, 95% CI 1.17‐1.23, AER = 22.8). Increased risks of SPCs were observed for the digestive system, urinary system and female and male reproductive organs. CRC incidence increased in younger persons (<50 years) and SPC incidence was 4‐fold in this group (SIR males 4.51, 95% CI 4.04‐5.01, AER = 64.2; SIR females 4.03, 95% CI 3.62‐4.48, AER = 77.0). Primary tumor‐related factors associated with SPC risk were right‐sided cancer and smaller primary tumor size. Treatment and risk of SPC differed for CC (no effect) and RC (lower risk after chemotherapy). CRC survivors have excess risk of developing SPC, with particular characteristics that could guide targeted surveillance.

show abstract

“…Compared to the general population, individuals diagnosed with colorectal cancer face a notably higher likelihood of developing extracolonic secondary primary cancers. Among these secondary cancers, a considerable portion is attributed to obesity-related cancers like endometrial cancer (EC) [9,10] . Aside from breast, ovarian, cervical, and colorectal cancers, EC is the second most prevalent primary cancer [11][12][13][14][15] , and Previous research has indicated that chemotherapy for breast cancer and radiotherapy for cervical cancer elevate the likelihood of SEC [16,17] .…”

Section: Introductionmentioning

confidence: 99%

Association between chemotherapy for surgically treated rectal cancer and second primary endometrial cancer

Gao,

Liu,

et al. 2023

Preprint

View full text Add to dashboard Cite

Background: The conventional approach to managing postoperative rectal cancer (RC) entails the administration of chemotherapy (CT) or radiotherapy, both of which carry the potential for adverse effects and the onset of various ailments. However, the potential association between CT treatment for rectal cancer in females and the incidence of second primary endometrial cancer (SEC), as well as its impact on survival rates within this demographic, remains unexplored. Consequently, our study endeavors to examine the potential correlation between CT for RC in females and the likelihood of developing SEC, as well as its implications for overall survival and cancer-specific survival in this particular cohort. Methods: This study employed the Surveillance, Epidemiology, and End Results database (SEER) as the primary data source, encompassing a substantial cohort of patients diagnosed with RC between 1975 and 2018. To ascertain the cumulative incidence of SEC and the relative risk (RR) associated with CT compared to no CT (NCT), Fine-Gray competing risk regressions and standardized incidence ratios (SIR) were utilized. Furthermore, the survival outcomes were assessed, encompassing the estimation of overall survival (OS) and cancer-specific survival (CSS) at 10 years. Results: This study involved a total of 30,847 individuals who were diagnosed with RC. Among them, 168 individuals (5.45‰) experienced SEC. Furthermore, 107 patients (3.47‰) received CT treatment, while 61 patients (1.98‰) received NCT. The analysis of the overall occurrence of SEC revealed a significant association between SEC and CT treatment (hazard ratio: 1.80; 95% confidence interval (CI): 1.39–2.34; P-value < 0.001). Both univariate and multivariate analyses confirmed a significant association between CT treatment and an increased risk of developing SEC in RC patients (univariate analyses hazard ratio, 2.06; 95% CI, 1.51–2.81; P-value < 0.001; multivariate analyses hazard ratio, 1.99; 95% CI, 1.44–2.75; P-value < 0.001). Through the implementation of a dynamic analysis on the variables of RR and SIR, it was discerned that the likelihood of SEC escalated in tandem with advancing age. The examination of patients who developed SEC received to CT and those who developed SEC did not revealed no substantial disparities in the 10-year overall survival rate and cancer-specific survival rate (10-year OS, 10.81‰ vs 5.18‰; P-value = 0.083; 10-year CSS, 8.29‰% vs 7.29‰; P-value = 0.270), and the result was the same situation after propensity score matching (PSM) (10-year OS, 5.18‰ vs 5.18‰; P = 0.082; 10-year CSS, 6.58‰ vs 6.58‰; P-value = 0.240). Nevertheless, a notable discrepancy emerged when comparing the overall survival rate and cancer-specific survival rate at 10 years between patients afflicted with secondary endometrial cancer (SEC) subsequent to CT and those afflicted with primary endometrial cancer (PEC). (10-year OS, 25.58‰ vs 5.59‰; P-value < 0.001; 10-year CSS, 25.28‰ vs 5.14‰; P-value < 0.001), and the result was the same situation in the NCT group (10-year OS, 8.20‰ vs 1.66‰; P-value < 0.001; 10-year CSS, 6.00‰ vs 1.20‰; P-value = 0.009). Conclusion: The utilization of CT in patients diagnosed with RC has been associated with an increased probability of developing specific SEC. Therefore, it is imperative to prioritize efforts aimed at reducing CT-related SEC occurrences and improving the prognosis of affected individuals.

show abstract

Risk of extracolonic second primary cancers following a primary colorectal cancer: a systematic review and meta-analysis

Cited by 9 publications

References 51 publications

Second Primary Cancers following Colorectal Cancer in Sicily, Italy

Second Primary Cancers following Colorectal Cancer in Sicily, Italy

Second primary cancer among 217702 colorectal cancer survivors: An analysis of national German cancer registry data

Association between chemotherapy for surgically treated rectal cancer and second primary endometrial cancer

Contact Info

Product

Resources

About