Clinical Characteristics and Risk of Second Primary Lung Cancer After Cervix Cancer: A Population-Based Study

Abstract

Background: Lung cancer as a second primary malignancy is increasingly common, but the clinical characteristics of second primary non-small cell lung cancer after cervix cancer (CC-NSCLC) in comparison with first primary non-small cell lung cancer (NSCLC1) is unknown.Methods: The Surveillance, Epidemiology and EndResults (SEER) cancer registry between 1998 and 2010 was used to conduct a large population-based cohort analysis. Demographic and clinical characteristics as well as prognostic data were systematically analyzed. We further compared overall survival (OS) in the two cohorts. Risk factors of secondary primary lung cancer in cervical cancer patients were also analyzed.Results: 557 (3.52%) had developed second primary lung cancer after cervix cancer and 451 were eligible for inclusion in the final analyses. In comparison to NSCLC1, patients with CC-NSCLC had a higher rate of squamous cell carcinoma (SCC) (36.59% vs. 19.07%, p<0.01). Median OS was longer for CC-NSCLC than for NSCLC1 before propensity score matching (PSM) (16 vs. 13months) but there was no significant difference after PSM. High-risk factors in cervical cancer to developing CC-NSCLC include: 50-79years old, black race (OR 1.417; 95%CI 1.095-1.834; p<0.05)and history of radiotherapy (OR 1.392; 95%CI 1.053-1.841; p<0.05).Conclusion: 50-79years old, black race and history of radiotherapy were independent risk factors of second primary lung cancer in cervical cancer patient. CC-NSCLC patients had distinctive clinical characteristics and a better prognosis compared with NSCLC1 patients.