African American race as a risk factor associated with a second primary lung cancer after initial primary head and neck cancer

Abstract

Background: Initial primary head and neck cancer (IPHNC) is associated with second primary lung cancer (SPLC). We studied this association in a population with a high proportion of African American (AA) patients.Methods: Patients with IPHNC and SPLC treated between 2000 and 2017 were reviewed for demographic, disease, and treatment-related characteristics and compared to age-and-stage-matched controls without SPLC. Logistic and Cox regression models were used to analyze the relationship of these characteristics with the development of SPLC and overall survival (OS).Results: Eighty-seven patients and controls were compared respectively. AA race was associated with a significantly higher risk of developing SPLC (OR 2.92, 95% CI 1.35-6.66). After correcting for immortal time bias, patients with SPLC had a significantly lower OS when compared with controls (HR 0.248, 95% CI 0.170-0.362). Conclusions: We show that AA race is associated with an increased risk of SPLC after IPHNC; reasons of this increased risk warrant further investigation.

Association between radiotherapy for surgically treated oral cavity cancer and secondary lung cancer

“…There may also be an interaction between tobacco and radiation in SLC (45). Conversely, other reports have shown that the risk of developing SLC was similar between smokers and neversmokers (49,50). Without further investigations, conclusions cannot be drawn regarding the association between the presence of SLC and smoking.…”

Time‐varying association of second primary malignancy and long‐term survival outcomes in patients with head and neck cancer

“…Some studies have reported a negative impact of SPM on the survival. [17][18][19][20] Yet, others demonstrated that the overall mortality rate was not significantly different between patients with and without SPM. 21,22 Thus, no conclusive evidence has been found on the survival impact of SPM development after diagnosing IP-HNSCC.…”

“…Nevertheless, the results were equivocal. Some studies have reported a negative impact of SPM on the survival 17‐20 . Yet, others demonstrated that the overall mortality rate was not significantly different between patients with and without SPM 21,22 .…”

“…Thus, no conclusive evidence has been found on the survival impact of SPM development after diagnosing IP‐HNSCC. Notably, the majority of these studies 17‐22 were limited by small sample size, failure to consider the SPM development as a time‐varying variable, short follow‐up and different follow‐up periods utilized for comparing IP‐HNSCC survivors who developed SPM with those without SPM. For example, patients with SPM were followed from the date of SPM diagnosis or treatment through the date of death or last follow‐up time, while patients with single index HNSCC were followed from the date of IP‐HNSCC diagnosis or treatment, when comparing the survival between SPM and single index HNSCC 18 .…”

“…21,22 Thus, no conclusive evidence has been found on the survival impact of SPM development after diagnosing IP-HNSCC. Notably, the majority of these studies [17][18][19][20][21][22] were limited by small sample size, failure to consider the SPM development as a time-varying variable, short follow-up and different follow-up periods utilized for comparing IP-HNSCC survivors who developed SPM with those without SPM. For example, patients with F I G U R E 3 Adjusted HRs for SPM among patients with SPM vs single primary HNSCC, stratified by patient and IP-HNSCC characteristics.…”