Increased risk of second primary malignancies following uterine cancer: a population-based study in Taiwan over a 30-year period

Abstract

BackgroundPrevious studies assessing second primary malignancies (SPMs) after uterine cancer have been conducted in Western populations with conflicting results. This study aimed to define the incidence and risk of SPMs in Taiwanese patients with an initial diagnosis of uterine cancer.MethodsUsing population-based data from the Taiwan Cancer Registry for the period 1979–2008, we quantified standardized incidence ratios (SIRs) among 11,571 women with an initial diagnosis of uterine cancer.ResultsAmong the 11,571 women, 555 (4.80 %) developed at least one SPM during 69,987 person-years of follow-up. There was a 71 % increased risk of SPM following uterine cancer (SIR = 1.71, 95 % CI, 1.57–1.86), with higher risks in the vagina/vulva (SIR = 9.06), small intestine (SIR = 8.45), ovary (SIR = 4.15), urinary bladder (SIR = 2.31), kidney (SIR = 2.24), colorectum (SIR = 2.24), lung (SIR = 1.96), and breast (SIR = 1.43). The risk of SPM was found to be the highest within the first 5 years after diagnosis of uterine cancer, with surveillance bias possibly contributing to the extremely high risk observed in the first follow-up year. The overall risk and pattern of SPM development observed in this study differed from those previously reported in Western populations, possibly because of the methodology and shorter follow-up period employed in this study. The cumulative incidence of SPMs was significantly higher in older patients (≥50 years) than in younger patients (P < 0.001).ConclusionsTo our knowledge, this is the first study in an Asian population to report 71 % increased risk in SPMs in women previously diagnosed with uterine cancer. A younger age at diagnosis of uterine cancer conferred an increased risk of second malignancies, and SPMs worsened survivorship in patients who survived uterine cancer.

Multiple primary cancers associated with endometrial and ovarian cancers: An analysis based upon the Japan Autopsy Annual Database from 2002 to 2010

“…This study revealed that the incidence rate of MPC with endometrial and ovarian cancer, which was evaluated using the autopsy database, was significantly high. Similar findings were reported from different populations in various regions, for example, Swede, Turk, and Taiwanese . The incidence between MPC with endometrial and ovarian cancers and those without these cancers was associated with the changes in the female endocrine system.…”

“…Similar findings were reported from different populations in various regions, for example, Swede, 24 Turk, 25 and Taiwanese. 26 The incidence between MPC with endometrial and ovarian cancers and those without these cancers was associated with the changes in the female endocrine system. Several cohorts demonstrated that the increased number of births reduced the risks of endometrial and/or ovarian cancer, 27,28 whereas hormone replacement therapy (HRT) significantly increased the risk of endometrial cancer.…”

The bidirectional association among female hormone‐related cancers: breast, ovary, and uterine corpus

“…The risk of second ovarian cancer is increased in young patients with primary uterine cancer . Hung et al.…”

“…The risk of second ovarian cancer is increased in young patients with primary uterine cancer [12,13]. Hung et al [14] found that patients with primary ovarian cancer also have an increased risk of second uterine cancer, but Levi showed that patients with ovarian cancer did not have any excess risk of any second cancer in his study that recruited 1530 subjects [15].…”

Risk of depression following uterine cancer: A nationwide population‐based study

“…The prognosis of uterine cancer in Taiwan is also favorable. A population‐based study reported that median survival was 24.50 years and the 5‐year survival rate was 80% . Therefore, uterine cancer could be considered as a chronic condition because of the favorable outcome.…”