The relative risk of second primary cancers in Austria’s western states: a retrospective cohort study

Abstract

BackgroundCancer survivors are at risk of developing a second primary cancer (SPC) later in life because of persisting effects of genetic and behavioural risk factors, the long-term sequelae of chemotherapy, radiotherapy and the passage of time. This is the first study with Austrian data on an array of entities, estimating the risk of SPCs in a population-based study by calculating standardized incidence ratios (SIRs).MethodsThis retrospective cohort study included all invasive incident cancer cases diagnosed within the years 1988 to 2005 being registered in the Tyrol and Vorarlberg Cancer Registries. Person years at risk (PYAR) were calculated from time of first diagnosis plus 2 months until the exit date, defined as the date of diagnosis of the SPC, date of death, or end of 2010, whichever came first. SIR for specific SPCs was calculated based on the risk of these patients for this specific cancer.ResultsA total of 59,638 patients were diagnosed with cancer between 1988 and 2005 and 4949 SPCs were observed in 399,535 person-years of follow-up (median 5.7 years). Overall, neither males (SIR 0.90; 95% CI 0.86–0.93) nor females (SIR 1.00; 95% CI 0.96–1.05) had a significantly increased SIR of developing a SPC. The SIR for SPC decreased with age showing a SIR of 1.24 (95% CI 1.12–1.35) in the age group of 15–49 and a SIR of 0.85 (95% CI 0.82–0.89) in the age group of ≥ 65. If the site of the first primary cancer was head/neck/larynx cancer in males and females (SIR 1.88, 95% CI 1.67–2.11 and 1.74, 95% CI 1.30–2.28), cervix cancer in females (SIR 1.40, 95% CI 1.14–1.70), bladder cancer in males (SIR 1.20, 95% CI 1.07–1.34), kidney cancer in males and females (SIR 1.22, 95% 1.04–1.42 and 1.29, 95% CI 1.03–1.59), thyroid gland cancer in females (SIR 1.40, 95% CI 1.11–1.75), patients showed elevated SIR, developing a SPC.ConclusionsSurvivors of head & neck, bladder/kidney, thyroid cancer and younger patients show elevated SIRs, developing a SPC. This has possible implications for surveillance strategies.Electronic supplementary materialThe online version of this article (10.1186/s12885-017-3683-9) contains supplementary material, which is available to authorized users.

The relative risk of second primary cancers in Switzerland: a population-based retrospective cohort study

“…In line with other studies [11,13,17,35], we found a consistent pattern of higher risks of SPC for youngonset patients. Notably, longer residual life expectancy itself is insufficient to explain our results as we calculated age-adjusted risks.…”

“…In line with other studies outside of Switzerland [35,40], we observed a significantly reduced risk of SPC for prostate cancer survivors. Prostate cancer is the most common cancer in males, leading to high numbers of expected cases.…”

“…However, overall increased risks of subsequent cancers were not systematically observed for all regions or countries and time periods investigated. A recent cancer registry study from Austria, for example, observed increased risks for single cancer sites, but no overall increased risk [35]. An Italian population-based study reported an overall significantly reduced risk (SIR 0.87) although the population size covered (< 2.5 million inhabitants in total) and the length of follow-up (mean: 2.5 years, < 50,000 person-years of follow-up) were relatively limited [36].…”

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

“…We identified one additional article by manually searching the references of the included articles (Chan, Gooi, Mydlarz, & Agrawal, 2016). A total of 26 studies (Boakye et al., 2018, 2019; Chan et al., 2016; Chen et al., 2008, 2011; Chow, Au, Mang, Cheung, & Risk, 2019; Chuang et al., 2008; Cianfriglia, Di Gregorio, & Manieri, 1999; Dikshit et al., 2005; Dong & Hemminki, 2001; Goggins et al., 2010; Jégu, Binder‐Foucard, Borel, & Velten, 2013; Jung, Lim, Jung, Ryu, & Won, 2015; Lee, Wang, Lu, Huang, & Chen, 2017; Levi, Randimbison, & Te, 2003; Levi, Te, Randimbison, Maspoli, & La Vecchia, 2006; Min et al., 2019; Morris, Sikora, Hayes, Patel, & Ganly, 2011; Neumann et al., 2016; Ooft & van Ipenburg, 2016; Preyer, Concin, Obermair, Concin, & Ulmer, 2017; Scélo et al., 2007; Sikora et al., 2009; Söderholm et al., 1994; Suk et al., 2018; Warnakulasuriya et al., 2003) met the eligibility criteria for this systematic review.…”

“…The main characteristics of the studies are shown in Table 1. Seventeen studies (77%) were carried out in the Western countries (eleven in Europe Cianfriglia et al., 1999; Dikshit et al., 2005; Dong & Hemminki, 2001; Jégu et al., 2013; Levi et al., 2003; Levi et al., 2006; Neumann et al., 2016; Ooft et al, 2016; Preyer et al., 2017; Söderholm et al., 1994; Warnakulasuriya et al., 2003), six (Boakye et al., 2018, 2019; Chan et al., 2016; Morris, Sikora, Hayes, et al, 2011; Sikora et al., 2009; Suk et al., 2018) in USA and three (Chuang et al., 2008; Dikshit et al., 2005; Scélo et al., 2007) were multicentre collaborations across Europe, Canada and Australia), and seven studies (22.7%) were conducted in Asian population (Taiwan [Chen et al., 2008;Chen et al., 2011;Lee et al., 2017], China [Chow et al., 2019;Goggins et al., 2010] and South Korea [Jung et al., 2015;Min et al., 2019]). Except three studies (Chow et al., 2019; Cianfriglia et al., 1999; Goggins et al., 2010) that used hospital‐based cancer registries, the other studies used population‐based cancer registries.…”