Second primary malignancies in colorectal cancer patients

Abstract

The prevalence of second primary malignancies (SPMs) in the western world is continually increasing with the risk of a new primary cancer in patients with previously diagnosed carcinoma at about 20%. The aim of this retrospective analysis is to identify SPMs in colorectal cancer patients in a single-institution cohort, describe the most frequent SPMs in colorectal cancer patients, and discover the time period to occurrence of second primary tumors. We identified 1174 patients diagnosed with colorectal cancer in the period 2003–2013, with follow-up till 31.12.2018, and median follow-up of 10.1 years, (median age 63 years, 724 men). A second primary neoplasm was diagnosed in 234 patients (19.9%). Older age patients, those with early-stage disease and those with no relapse have a higher risk of secondary cancer development. The median time from cancer diagnosis to development of CRC was 8.9 years for breast cancer and 3.4 years for prostate cancer. For the most common cancer diagnosis after primary CRC, the median time to development was 0–5.2 years, depending on the type of malignancy. Patients with a diagnosis of breast, prostate, or kidney cancer, or melanoma should be regularly screened for CRC. CRC patients should also be screened for additional CRC as well as cancers of the breast, prostate, kidney, and bladder. The screening of cancer patients for the most frequent malignancies along with systematic patient education in this field should be the standard of surveillance for colorectal cancer patients.

Multiple Primary Tumors Originating From the Prostate and Colorectum A Clinical-Pathological and Therapeutic Challenge

“…Compared with Sturludóttir et al, who analyzed the association between PC and rectal cancer over a period of 16 years, Jacobs et al reported a twofold higher incidence for synchronous PC and rectosigmoid cancer over a period of 20 years ( Jacobs et al, 2020 ; Sturludóttir et al, 2015 ). Another study from Czech Republic showed that 2.3% of patients diagnosed with CRC between 2003 and 2013 and followed until 2018 developed PC ( Halamkova et al, 2021 ), in line with a Swedish study that has shown that 1.9% of those over 72,000 patients have associated colon cancer and PC ( Van Hemelrijck et al, 2012 ). The incidence of 5% for D/MPMTs identified in our study is significantly higher compared with the aforementioned studies.…”

“…The incidence of D/MPMTs in which one of the tumors was PC varies between 1.14% ( Jin et al, 2014 ) and 8.7% ( Weir et al, 2013 ), while the cases in which one of the multiple tumors was a CRC had an incidence up to 19.9% ( Halamkova et al, 2021 ). A Dutch study that included almost 430,000 patients diagnosed with at least one form of cancer reported a prevalence of 7% for multiple malignancies, and 0.3% for the association of PC with CRC ( L. Liu et al, 2011 ).…”

Common anti-cancer therapies induce somatic mutations in stem cells of healthy tissue

“…In line with this, a similar platinum-induced mutational load (430 SBSs) was previously reported in colon crypts of a single patient treated with cisplatin 24 . With an estimated 10 8 colorectal stem cells 25 in the adult colon, each platinum treatment leads to an enormous pool of potentially deleterious mutations that may explain why platinum drugs pose an increased risk for the development of secondary malignancies 26 .…”

Lifetime Attributable Risk Estimates of Secondary Cancer after External Radiotherapy among Colorectal Cancer Survivors in Saudi Arabia

“…The risk of secondary CRC amongst patients caused by first cancer radiotherapy treatment is an area of debate in clinical radiation oncology. The biggest challenge in evaluating the second CRC risk is the latency period of onset following initial radiotherapy treatment [46][47][48] . This recurrence is expected to occur many years after the first diagnosis 49 .…”