The effect of patient characteristics on second primary cancer risk in France

Abstract

BackgroundAlthough cancer survivors are known to be at greater risk of developing second primary cancer (SPC), SPC incidence estimates in France are thus far lacking. We used a multivariate approach to compute these estimates and analyzed the effect of patient characteristics (gender, age at diagnosis, first cancer site, year of diagnosis and follow-up) on SPC risk.MethodsData from ten French population-based cancer registries were used to establish a cohort of all patients diagnosed with a first cancer between 1989 and 2004 and followed up until December 31, 2007. The person-year approach was used to estimate standardized incidence ratios (SIRs) and excess absolute risks (EARs) of metachronous SPC. Multivariate Poisson regression models were then used to model SIRs and EARs separately by gender, adjusting for age, year of diagnosis, follow-up and first cancer site.ResultsAmong the 289,967 followed-up patients with a first primary cancer, 21,226 developed a SPC. The SIR was of 1.36 (95% CI, 1.35-1.38) and the EAR was of 39.4 excess cancers per 10,000 person-years (95% CI, 37.4-41.3). Among male and female patients, multivariate analyses showed that age, year of diagnosis, follow-up and first cancer site were often independently associated with SIRs and EARs. Moreover, the EAR of SPC remained elevated during patient follow-up.ConclusionsFrench cancer survivors face a dramatically increased risk of SPC which is probably related to the high rate of tobacco and alcohol consumption in France. Multivariate modeling of SPC risk will facilitate the construction of a tailored prediction tool to optimize SPC prevention and early detection strategies.

Temporal trends in the risk of developing multiple primary cancers: a systematic review

“…26 were peer-reviewed publications, reporting on more than 2.8 million survivors of adult cancer over the period of 1943 to 2012 [31–56], with 178,091 MPCs identified. Four of them reported the risk of developing MPCs following first cancer with all sites combined [45, 46, 48, 52]. Others focused on the risk of MPCs following first cancer at a specific site.…”

“…Seven studies and the SEER monograph used incidence and follow-up data from SEER program registries, and employed SEER coding rules [7, 39–44, 53]. Eight studies and the Italian monograph used coding rules proposed by the IARC/IACR [37, 38, 45, 47, 48, 50, 52, 56, 57]. While it may be difficult to directly compare risk estimates derived using different coding rules, comparisons of temporal trends will be valid if the rules used to define MPCs are consistent over time within a single study population [58].…”

“…The Italian monograph reported SIRs of 1.10 in 1978–1987, 1.08 in 1988–1997 and 1.10 in 1998–2010, with a 10 % higher risk of developing MPCs than expected across the entire study period 1976–2010 (SIR, 1.10; 95%CI, 1.09 to 1.10) [57]. The French study was a large population-based study using data from 10 French population-based cancer registries, with a first cancer diagnosis between 1989 and 2004 [48]. …”

“…Temporal trends in population exposure to carcinogenic factors such as alcohol and tobacco consumption, differed across countries [48]. Any differences over time in exposure in the reference population compared with the population of cancer survivors could contribute to changing SIRs.…”

Genetic polymorphisms of CYP3A4 1B of cervical cancer patients in Bangladeshi population, Bangladesh

“…8 Cervical cancer risk is privileged in those of vaginal, kidney, urinary tract, or skin cancers. 9,10 Carcinoma risk in squamous cell in cervix is 74-80% privileged in women with their relative like mother, sister, daughter in comparison with general women. 11 In high-income countries the incidence rates were similar as those in the developing world since 1960 and 1970s.…”