Incidence and relative risk of metachronous second primary cancers for 16 cancer sites, Osaka, Japan, 2000–2015: Population‐based analysis

Abstract

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Risks of Second Non-Breast Primaries Following Breast Cancer in Women: A Systematic Review and Meta-Analysis

“…The reported SIRs ranged from 0.84 (3) to 1.84 (24). All but ve (3,7,19,21,24) estimated SIRs ranging between 1.00 and 1.50.…”

“…Larger studies comparing SPC counts observed under these two common sets of guidelines would help clarify this issue. However, even if SPC coding discrepancies do account for the majority of the heterogeneity contributed by Diab et al, this would not explain the rest of the heterogeneity, which remained signi cant even following the elimination of four further studies identi ed as major drivers of heterogeneity (7,11,20,24). It is likely that including studies from three different continents contributed to heterogeneity, since SPC risks in these continents were found to vary signi cantly.…”

“…Fifteen studies excluded data on second primaries occurring within some given follow-up duration following the rst BC diagnosis (2)(3)(4)(8)(9)(10)12,14,19,(21)(22)(23)(24)26,27). All other studies included data on second primaries diagnosed immediately following the rst BC, although the study by the AIRTUM Working Group (1) also gave a separate analysis excluding SPCs diagnosed in the rst 2 months of follow-up.…”

“…This is known as "detection bias", and we cannot rule out that it may have affected some results in this review (1). However, many studies were included that excluded SPCs diagnosed within some time period following the rst BC (2)(3)(4)(8)(9)(10)12,14,19,(21)(22)(23)(24)26,27) when detection bias is likely to be most pronounced (1). Therefore, detection bias is unlikely to be a major weakness of this review.…”

“…This review adds to the previously published review (34) in several ways. Firstly, the previous review included no studies published since June 2013, whereas this updated review included twelve studies published since (1,5,6,9,13,17,18,20,21,24,25,28). This review also includes studies with cohorts consisting of survivors of any given set of initial cancers provided SPC risks could be extracted for the subset of BC survivors, yielding three new studies published before June 2013 (16,26,27).…”