Impact of prior cancer history on the overall survival of patients newly diagnosed with cancer: A pan‐cancer analysis of the SEER database

Abstract

The population of cancer survivors with prior cancer is rapidly growing. Whether a prior cancer diagnosis interferes with outcome is unknown. We conducted a pan-cancer analysis to determine the impact of prior cancer history for patients newly diagnosed with cancer. We identified 20 types of primary solid tumors between 2004 and 2008 in the Surveillance, Epidemiology, and End Results database. Demographic and clinicopathologic variables were compared by χ test and t-test as appropriate. The propensity score-adjusted Kaplan-Meier method and Cox proportional hazards models were used to evaluate the impact of prior cancer on overall survival (OS). Among 1,557,663 eligible patients, 261,474 (16.79%) had a history of prior cancer. More than 65% of prior cancers were diagnosed within 5 years. We classified 20 cancer sites into two groups (PCI and PCS) according to the different impacts of prior cancer on OS. PCI patients with a prior cancer history, which involved the colon and rectum, bone and soft tissues, melanoma, breast, cervix uteri, corpus and uterus, prostate, urinary bladder, kidney and renal pelvis, eye and orbits, thyroid, had inferior OS. The PCS patients (nasopharynx, esophagus, stomach, liver, gallbladder, pancreas, lung, ovary and brain) with a prior cancer history showed similar OS to that of patients without prior cancer. Our pan-cancer study presents the landscape for the survival impact of prior cancer across 20 cancer types. Compared to the patients without prior cancer, the PCI group had inferior OS, while the PCS group had similar OS. Further studies are still needed.

Survival disparities for second primary malignancies diagnosed among childhood cancer survivors: A population‐based assessment

“…21,22 The results of this study indicate that the increase in cancer-specific mortality is likely attributable to a combination of both an increase in the incidence of SPMs 3 and poorer relative survival after an SPM diagnosis. 26,27 Keegan et al 27 evaluated differences in survival by age at SPM and observed that the 5-year OS rate was 33% lower for individuals diagnosed with an SPM at an age <15 years, 20% lower for individuals diagnosed with an SPM at an age of 15 to 39 years, and 8% lower for individuals diagnosed with an SPM at an age ≥40 years. Disparities in OS were observed for survivors of childhood cancer independently of demographic factors, the age at the childhood cancer diagnosis, the time from childhood cancer to the SPM diagnosis, and exposure to radiotherapy during childhood.…”

“…Few studies have evaluated the impact of a prior cancer history on subsequent cancer outcomes among adults with prostate, lung, or gastrointestinal cancers. [23][24][25] Zhou et al 26 recently explored whether a history of any prior cancer adversely influenced survival across 20 adult cancer sites. Although the HRs were attenuated in comparison with those observed in the current study, a history of prior cancer was associated with inferior outcomes for secondary breast cancer (HR, 1.27; 95% CI, 1.24-1.30), melanoma (HR, 1.23; 95% CI, 1.19-1.27), bone and soft-tissue sarcoma (HR, 1.17; 95% CI, 1.09-1.25), and thyroid cancer (HR, 1.56; 95% CI, 1.43-1.69).…”

“…Notably, our results are consistent with previous reports showing that a prior history of cancer is associated with larger relative differences in survival for cancers with generally favorable outcomes, such as thyroid cancer, breast cancer, and melanoma. 26,27 Keegan et al 27 evaluated differences in survival by age at SPM and observed that the 5-year OS rate was 33% lower for individuals diagnosed with an SPM at an age <15 years, 20% lower for individuals diagnosed with an SPM at an age of 15 to 39 years, and 8% lower for individuals diagnosed with an SPM at an age ≥40 years. We did not observe survival differences across age at SPM; however, we did observe elevated HRs for individuals diagnosed with a childhood cancer at <10 years of age or diagnosed with an SPM within 10 years of their initial childhood cancer.…”

Impact of Prior Cancer on Outcomes in Nasopharyngeal Carcinoma

“…Our previous study has mentioned the different impact of prior cancer according to the specific cancer (8). We creatively divided these cancers into two categories, "prior cancer inferior" (PCI), in which patients had lower survival rates than those without prior cancer; and "prior cancer similar" (PCS), in which survival rates were similar.…”

“…This practice is mainly based on the long-held assumption that prior cancer diagnosis and treatment could interfere with study outcomes. However, our previous pan-cancer study suggested that not all prior cancers actually interfere with study outcomes (8). The number of cancer survivors has a 4-fold increase in the United States over the last three decades (9).…”