Incidence of second and higher order smoking-related primary cancers following lung cancer: a population-based cohort study

Abstract

BackgroundLung cancer 5-year survival has doubled over 15 years. Although the risk of second primary cancer is recognised, quantification over time is lacking. We describe the incidence of second and higher order smoking-related primary cancers in lung cancer survivors, identifying high-incidence groups and how incidence changes over time from first diagnosis.MethodsData on smoking-related primary cancers (lung, laryngeal, head and neck, oesophageal squamous cell carcinoma and bladder) diagnosed in England between 2000 and 2014 were obtained from Public Health England National Cancer Registration and Analysis Service. We calculated absolute incidence rates and standardised incidence rate ratios, both overall and for various subgroups of second primary cancer for up to 10 years from the initial diagnosis of lung cancer, using Poisson regression.ResultsElevated incidence of smoking-related second primary cancer persists for at least 10 years from first lung cancer diagnosis with those aged 50 and 79 at first diagnosis at particularly high risk. The most frequent type of second malignancy was lung cancer although the highest standardised incidence rate ratios were for oesophageal squamous cell carcinoma (2.4) and laryngeal cancers (2.8) and consistently higher in women than in men. Over the last decade, the incidence of second primary lung cancer has doubled.ConclusionLung cancer survivors have increased the incidence of subsequent lung, laryngeal, head and neck and oesophageal squamous cell carcinoma for at least a decade from the first diagnosis. Consideration should be given to increasing routine follow-up from 5 years to 10 years for those at highest risk, alongside surveillance for other smoking-related cancers.

Occurrence of metachronous second primary cancer in head and neck cancer survivors: A systematic review and meta‐analysis of the literature

“…Although the carcinogenic effects of tobacco smoking and alcohol are widely described (Do et al., 2004), the included studies did not reported data for these risk factors before and after the primary diagnosis, probably because they used cancer registries databases, which did not report this information. Our findings are in line with the published evidence of increased SPC risk among HNC patients with alcohol and tobacco consumption (Barclay et al., 2019). The HPV status was not available in the studies pooled in the primary analyses; thus, the direct effect of HPV infection is difficult to distinguish from the effects of smoking and alcohol consumption.…”

Characterization of long non-coding RNA and messenger RNA profiles in laryngeal cancer by weighted gene co-expression network analysis

“…Even with advancement in medical technology, the five year survival rate was still devastating in advanced LC patients. Various factors can increase the risk of LC; smoking is a leading cause [24]. There is also evidence of a link between consumption of alcohol without food and high incidence of LC [25].…”

Risk of Second Primary Malignancies in Colon Cancer Patients Treated With Colectomy

“…Unfortunately, it was reported that more than 8% of these survivors were facing the probability of progressing a second primary malignancy (SPM) ( 5 ) and SPM becomes one of the main causes of death for those patients ( 6 ). Hence, there are a growing number of studies exploring the risk factors of SPM in different cancer survivors such as breast ( 7 ), lung ( 8 ) as well as colorectal cancer ( 9 , 10 ). However, these studies used logistic regressions or Cox proportional hazard regressions to analyze SPM-related factors, which ignored the death as a competing event for occurring PSMs.…”