Second Primary Cancers After Gastric Cancer, and Gastric Cancer as Second Primary Cancer

Abstract

Background Second primary cancers (SPCs) are increasing, which may negatively influence patient survival. Gastric cancer (GC) has poor survival and when it is diagnosed as SPC it is often the cause of death. We wanted to analyze the risk of SPCs after GC and the risk of GC as SPC after any cancer. Such bidirectional analysis is important in relation to fatal cancers because SPCs may be under-reported in the short-term survival period. Methods Cancers were obtained from the Swedish Cancer Registry from years 1990 through 2015. Standardized incidence ratios (SIRs) were used to estimate bidirectional relative. Results We identified 23,137 GC patients who developed 1042 SPCs (4.5%); 2158 patients had GC as SPC. While the risk for three SPCs was increased after GC, seven first primary cancers were followed by an increased risk of GC as SPC, including esophageal, colorectal, bladder, squamous cell skin and breast cancers and non-Hodgkin lymphoma. Breast cancer, which was followed by a diagnosis of second GC, showed an excess of lobular histology. Conclusion Multiple primary cancers in the same individuals may signal genetic predisposition. Accordingly, the association of GC with breast cancer may be related to mutations in the CDH1 gene, and clustering of colorectal, small intestinal and bladder cancers could be related to Lynch syndrome. The third line of findings supports a contribution of immune dysfunction on the increased risk of GC as SPC after skin cancer and non-Hodgkin lymphoma. Early detection of GC in the risk groups could save lives.

Causes of Death Following Gastric Cancer Diagnosis: A Population-Based Analysis

“…These findings suggest that proper screening for other cancers after a diagnosis of GC may be crucial for these patients. A previous study from the Swedish Cancer Registry, conducted from 1990 to 2015, also revealed that patients with GC have a significantly increased risk of developing secondary primary cancers, such as small intestinal, esophageal, and kidney cancers [ 36 ]. Thus, it is important for patients with GC to be aware of their increased risk for other cancers and to undergo appropriate follow-up and screenings.…”

Clinical characteristics and prognostic nomogram analysis of patients with dual primary cancers with first gastric cancer: a retrospective study in China

“…With technological advances in the diagnosis and treatment of GC, the number of survivors with new primary malignant tumors has been increasing each year ( Sung et al, 2021 ). According to the latest cancer report, the incidence of GC together with MPMNs ranges from 3.4% to 7.3% ( Zheng et al, 2021 ), and the 10-year cumulative mortality due to GC with MPMNs is 1.5–2 times higher than that due to single GC ( Morais et al, 2020a ). However, because of the sporadic clinical onset of GC with MPMNs and the lack of international standardized treatment guidelines, clinicians have a poor understanding of this disease.…”

Secondary Primary Cancer after Primary Gastric Cancer: Literature Review and Big Data Analysis Using the Health Insurance Review and Assessment Service (HIRA) Database of Republic of Korea

“…Nationwide population-based studies in Japan, Taiwan, United States of America, Portugal, and Sweden are available and listed in Table 2 [ 20 , 21 , 22 , 23 , 24 ]. The incidence of SPCs in patients with gastric cancer ranges from 4.4% to 5.5%.…”