Mode of primary cancer detection as an indicator of screening practice for second primary cancer in cancer survivors: a nationwide survey in Korea

Abstract

BackgroundWhile knowledge and risk perception have been associated with screening for second primary cancer (SPC), there are no clinically useful indicators to identify who is at risk of not being properly screened for SPC. We investigated whether the mode of primary cancer detection (i.e. screen-detected vs. non-screen-detected) is associated with subsequent completion of all appropriate SPC screening in cancer survivors.MethodsData were collected from cancer patients treated at the National Cancer Center and nine regional cancer centers across Korea. A total of 512 cancer survivors older than 40, time since diagnosis more than 2 years, and whose first primary cancer was not advanced or metastasized were selected. Multivariate logistic regression was used to examine factors, including mode of primary cancer detection, associated with completion of all appropriate SPC screening according to national cancer screening guidelines.ResultsBeing screen-detected for their first primary cancer was found to be significantly associated with completion of all appropriate SPC screening (adjusted odds ratio, 2.13; 95% confidence interval, 1.36–3.33), after controlling for demographic and clinical variables. Screen-detected cancer survivors were significantly more likely to have higher household income, have other comorbidities, and be within 5 years since diagnosis.ConclusionsThe mode of primary cancer detection, a readily available clinical information, can be used as an indicator for screening practice for SPC in cancer survivors. Education about the importance of SPC screening will be helpful particularly for cancer survivors whose primary cancer was not screen-detected.

Breast and Cervical Cancer Screening Behavior in Female Cancer Survivors: The Korea National Health and Nutrition Examination Survey, 2007–2012

“…However, of colon cancer survivors, only 52.7% had breast cancer screening and 37.5% had cervical cancer screening, which was lower than the rates in non-cancer controls. These findings were consistent with previous studies 132024). However, in previous studies, the much lower rate of SPC screening for female colon cancer survivors was noted as a weak point of their health care and promotion policy.…”

“…Generally, the rate of SPC screening declines with time since the primary cancer diagnosis 132429). Accordingly, the cancer survivors in our study surviving more than 10 years after their cancer diagnosis were less likely to undergo cervical cancer screening, which was thought to be due to the fact that they were too old to undergo routine cervical cancer screening.…”

Coupling of Prostate and Thyroid Cancer Diagnoses in the United States

“…16 This phenomenon occurs when some patients are followed more closely or have more diagnostic tests performed than others, which leads to a more frequent diagnosis assignment in the more closely monitored group. 15 Although overall population-wide rates of recommended screening are low, 14 cancer survivors are more likely to undergo cancer screening compared to the general population. 29–31 Among cancer survivors, increased understanding of the disease, risk perception, and mode of primary cancer detection are associated with screening for second primary cancers, and screen-detected cancer survivors are approximately twice as likely to receive all appropriate second primary cancer surveillance, even after controlling for other covariates known to affect cancer screening behaviors.…”

“…29–31 Among cancer survivors, increased understanding of the disease, risk perception, and mode of primary cancer detection are associated with screening for second primary cancers, and screen-detected cancer survivors are approximately twice as likely to receive all appropriate second primary cancer surveillance, even after controlling for other covariates known to affect cancer screening behaviors. 14 Heightened detection efforts may increase compliance with screening guidelines, but could also result in diagnosis of cancers of limited clinical significance. Such surveillance bias likely contributes to diagnosis of secondary malignancy in patients with thyroid and prostate cancer.…”

“…12,13 Increased long-term surveillance of individuals who have undergone cancer treatments influences subsequent cancer detection – a phenomenon known as surveillance bias. 12–1415–17 The type of care an individual receives may influence the likelihood of future cancer detection. For instance, exposure to urologic care for treatment of non-prostate-related malignancy significantly increases the likelihood of CAP detection, but not prostate cancer death.…”