Janice S Kwon1, Laurie Elit, Refik Saskin, David Hodgson, Eva Grunfeld. 1. From the University of British Columbia, Vancouver, British Columbia; Juravinski Cancer Centre, Hamilton, Ontario; Institute for Clinical Evaluative Sciences, Toronto, Ontario; Princess Margaret Hospital, Toronto, Ontario; and University of Toronto, Ontario, Canada.
Abstract
OBJECTIVE: To conduct a population-based study of incidence and screening rates for secondary breast and colorectal cancers after endometrial cancer and to assess implications for follow-up. METHODS: This was a retrospective population-based study from administrative databases. The inception cohort included all women diagnosed with endometrial cancer in Ontario, Canada from 1996 to 2000, without a previous history of breast or colorectal cancer. We ascertained 5-year recurrence and overall survival rates and practitioner type during follow-up. Primary outcomes were age-standardized incidence and screening rates of breast and colorectal cancer during follow-up compared with the general female population. RESULTS: There were 3,473 women in the cohort. The 5-year recurrence rate was 15.0% and overall survival was 79.3%. Family physicians were most often involved in follow-up care. Age-standardized incidence rates of breast and colorectal cancer were 0.5% and 0.7%, respectively, compared with 0.5% (P=.76) and 0.2% (P<.001) in the general population. Age-standardized screening rates for these cancers were 64.0% and 30.0%, respectively, compared with 31.0% (P<.008) and 15.0% (P<.001) in the general population. Women aged older than 70 years and those with the lowest income were least likely to have secondary cancer screening. CONCLUSION: Women with endometrial cancer have a comparable risk of breast cancer but higher risk of colorectal cancer compared with the general population. Follow-up after endometrial cancer should include counseling and uptake of secondary cancer prevention strategies, which will contribute to maximizing long-term survivorship for these women. LEVEL OF EVIDENCE: II.
OBJECTIVE: To conduct a population-based study of incidence and screening rates for secondary breast and colorectal cancers after endometrial cancer and to assess implications for follow-up. METHODS: This was a retrospective population-based study from administrative databases. The inception cohort included all women diagnosed with endometrial cancer in Ontario, Canada from 1996 to 2000, without a previous history of breast or colorectal cancer. We ascertained 5-year recurrence and overall survival rates and practitioner type during follow-up. Primary outcomes were age-standardized incidence and screening rates of breast and colorectal cancer during follow-up compared with the general female population. RESULTS: There were 3,473 women in the cohort. The 5-year recurrence rate was 15.0% and overall survival was 79.3%. Family physicians were most often involved in follow-up care. Age-standardized incidence rates of breast and colorectal cancer were 0.5% and 0.7%, respectively, compared with 0.5% (P=.76) and 0.2% (P<.001) in the general population. Age-standardized screening rates for these cancers were 64.0% and 30.0%, respectively, compared with 31.0% (P<.008) and 15.0% (P<.001) in the general population. Women aged older than 70 years and those with the lowest income were least likely to have secondary cancer screening. CONCLUSION:Women with endometrial cancer have a comparable risk of breast cancer but higher risk of colorectal cancer compared with the general population. Follow-up after endometrial cancer should include counseling and uptake of secondary cancer prevention strategies, which will contribute to maximizing long-term survivorship for these women. LEVEL OF EVIDENCE: II.
Authors: Stefano Uccella; Stephen S Cha; L Joseph Melton; Eric J Bergstralh; Lisa A Boardman; Gary L Keeney; Karl C Podratz; Fabio Francesco Ciancio; Andrea Mariani Journal: Int J Gynecol Cancer Date: 2011-07 Impact factor: 3.437
Authors: Eva Grunfeld; Rahim Moineddin; Nadia Gunraj; M Elisabeth Del Giudice; David C Hodgson; Janice S Kwon; Laurie Elit Journal: Can Fam Physician Date: 2012-09 Impact factor: 3.275
Authors: Mark Corkum; Jill A Hayden; George Kephart; Robin Urquhart; Coralynne Schlievert; Geoffrey Porter Journal: J Cancer Surviv Date: 2013-05-05 Impact factor: 4.442