Risk for a second primary hypopharyngeal and esophageal cancer after an initial primary oral cancer

Abstract

Objective: To investigate the risk for second primary cancer in the hypopharynx and esophagus (SPC-HE) among individuals with an initial oral/oropharyngeal cancer. Materials and Methods:Mass screening data from Taiwan (2004Taiwan ( -2009) included individuals who were ≥18 years old and smoked cigarettes and/or chewed betel quid.Occurrence of SPC-HE was monitored until December 31, 2014. Results were expressed as adjusted relative risk (aRR) and 95% confidence interval (CI). Results:One hundred and fifty-eight out of 4,494 subjects with oral cancer developed SPC-HE (incidence rate: 6.47 per 1,000 person-years). Relative to patients with primary cancers in the lip, the risk of an SPC-HE was higher in patients with primary cancers in oropharynx (aRR: 19.98, 95% CI: 4.72-84.55), floor of mouth (aRR: 12.13, 95% CI: 2.67-55.15), and hard palate (aRR: 7.31, 95% CI: 1.65-32.37), but not in patients with cancers in tongue (aRR: 3.67, 95% CI: 0.89-15.17) or gum (aRR: 3.99, 95% CI: 0.92-17.35). Regression analyses also showed the risk of an SPC-HE was greater in alcohol drinkers than those who did not (aRR: 1.65, 95% CI: 1.10-2.48). Conclusions:Compared with the initial cancer in the lip, patients with a cancer in the oropharynx, floor of mouth, and hard palate had a higher risk for the SPC-HE.

Factors associated with the development of second primary tumours in head and neck cancer patients

“…Ten out of 22 studies found that drinking alcohol increased the risk of developing SPTs (Bertolini et al, 2021 ; Bugter et al, 2021 ; Hosokawa et al, 2018 ; Inoue et al, 2021 ; Leoncini et al, 2018 ; Ni et al, 2018 ; Overwater et al, 2022 ; Su et al, 2019 ; Wang et al, 2017 ; Wang et al, 2019 ), whereas 12 of those studies did not find any association. The categories to define alcohol consumption varied among studies, but overall, a dose response was observed, with risks ranging from 1.006 (95% CI: 1.004–1.009) to 8.12 (95% CI: 4.15–15.92) for the increase of units per week or for highest category compared to never or non‐heavy drinkers.…”

“…From a total of 829 articles obtained after deleting duplicates, 703 were excluded based on title and abstract and 126 after reading the full text (Figure 1 ). Finally, 38 articles were included in this systematic review: 36 cohort studies (Adams et al, 2019 ; Adjei Boakye et al, 2019 ; Arie et al, 2021 ; Bertolini et al, 2021 ; Bosshart et al, 2021 ; Bugter et al, 2021 ; Bukovszky et al, 2022 ; Cadoni et al, 2017 ; Chow et al, 2019 ; Feng et al, 2017 ; Guo et al, 2021 ; Harada et al, 2017 ; Ho et al, 2022 ; Hosokawa et al, 2018 ; Inoue et al, 2021 ; Iwatsubo et al, 2019 ; León et al, 2020 ; Leoncini et al, 2018 ; Li et al, 2020 ; Lin et al, 2020 ; Liu et al, 2017 ; Martel et al, 2017 ; Milliet et al, 2021 ; Min et al, 2019 ; Nishimura et al, 2021 ; Overwater et al, 2022 ; Petersen et al, 2022 ; Piersiala et al, 2020 ; Sawaf et al, 2022 ; Stepan et al, 2022 ; Su et al, 2019 ; Su et al, 2020 ; Tseng et al, 2017 ; Wang et al, 2017 ; Wang et al, 2019 ; Zhang et al, 2019 ) and 2 case‐control studies (Ni et al, 2018 ; Watanabe et al, 2017 ).…”

“…The categories to define alcohol consumption varied among studies, but overall, a dose response was observed, with risks ranging from 1.006 (95% CI: 1.004–1.009) to 8.12 (95% CI: 4.15–15.92) for the increase of units per week or for highest category compared to never or non‐heavy drinkers. Of note, most of the studies that found an association between alcohol and the risk of SPTs reported the oesophagus as the main location of the SPT (Bugter et al, 2021 ; Hosokawa et al, 2018 ; Ni et al, 2018 ; Overwater et al, 2022 ; Su et al, 2019 ; Wang et al, 2017 ; Wang et al, 2019 ).…”

“…Ten out of 22 studies found that drinking alcohol increased the risk of developing SPTs (Bertolini et al, 2021;Bugter et al, 2021;Hosokawa et al, 2018;Inoue et al, 2021;Leoncini et al, 2018;Ni et al, 2018;Overwater et al, 2022;Su et al, 2019;Wang et al, 2017;Wang et al, 2019), whereas 12 of those studies did not find any association.…”

Alcohol Consumption, ALDH2 Polymorphism as Risk Factors for Upper Aerodigestive Tract Cancer Progression and Prognosis

“…Based on data compiled from >2.3 million oral exams between 2004–2009, it was shown that patients with head and neck cancer in the locations of hypopharynx, floor of mouth, and hard palate, but not in tongue or gum, had a greater chance of developing secondary primary cancer in the hypopharynx and esophagus. In addition, alcohol drinkers were at higher risks for second primary cancer in these two regions than non-alcohol drinkers [ 42 ]. Chien et al examined 659 male patients with head and neck cancers in Taiwan over a period of 20 years with a minimum of 2-year follow ups and a mean follow-up period of 47.13 months for the patients [ 43 ].…”