Melina Arnold1, Lifang Liu2, Gemma G Kenter3, Carien L Creutzberg4, Jan Willem Coebergh5, Isabelle Soerjomataram6. 1. Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands; Section of Cancer Information, International Agency for Research on Cancer, Lyon, France. 2. Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands. 3. Department of Obstetrics and Gynecology, Center for Gynecologic Oncology, Amsterdam, The Netherlands. 4. Department of Clinical Oncology, Leiden University Medical Center, The Netherlands. 5. Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands; Comprehensive Cancer Center South, Eindhoven Cancer Registry, Eindhoven, The Netherlands. Electronic address: j.coebergh@erasmusmc.nl. 6. Section of Cancer Information, International Agency for Research on Cancer, Lyon, France.
Abstract
BACKGROUND AND PURPOSE: We investigated the effects of socio-demographic, treatment- and tumor-specific determinants on the risk of developing a second malignancy among patients treated for cervical cancer. MATERIAL AND METHODS: We included patients with a first cervical cancer (N=12,048) from the Netherlands Cancer Registry (NCR), 1989-2008. Standardized incidence ratios (SIR) and absolute excess risks (AER) per 10,000 person-years were calculated to estimate the burden of second cancers in cervical cancer survivors. Incidence rate ratios (IRR) were computed to identify predictors for second cancers among cervical cancer survivors. RESULTS: During the study period, 676 (5.6%) patients were diagnosed with a second cancer. Smoking-related cancers contributed the most to the overall burden of second cancers (AER=21) and risks remained elevated after 10 years of follow-up (SIR=1.8, 95% CI: 1.4-2.2), yet it decreased markedly in the younger birth cohorts. Cervical cancer survivors who underwent radiotherapy were at higher risk for a second tumor when compared to those without radiotherapy, especially at smoking-related sites (IRR=1.6 (1.2-2.3)). CONCLUSION: Patients with cervical cancer had a significantly increased risk for a second cancer compared to the general population, especially for smoking- and irradiation-related tumors. Long-term follow-up suggested the importance of smoking cessation and the benefits of counseling cervical cancer patients accordingly, particularly those who received radiotherapy.
BACKGROUND AND PURPOSE: We investigated the effects of socio-demographic, treatment- and tumor-specific determinants on the risk of developing a second malignancy among patients treated for cervical cancer. MATERIAL AND METHODS: We included patients with a first cervical cancer (N=12,048) from the Netherlands Cancer Registry (NCR), 1989-2008. Standardized incidence ratios (SIR) and absolute excess risks (AER) per 10,000 person-years were calculated to estimate the burden of second cancers in cervical cancer survivors. Incidence rate ratios (IRR) were computed to identify predictors for second cancers among cervical cancer survivors. RESULTS: During the study period, 676 (5.6%) patients were diagnosed with a second cancer. Smoking-related cancers contributed the most to the overall burden of second cancers (AER=21) and risks remained elevated after 10 years of follow-up (SIR=1.8, 95% CI: 1.4-2.2), yet it decreased markedly in the younger birth cohorts. Cervical cancer survivors who underwent radiotherapy were at higher risk for a second tumor when compared to those without radiotherapy, especially at smoking-related sites (IRR=1.6 (1.2-2.3)). CONCLUSION:Patients with cervical cancer had a significantly increased risk for a second cancer compared to the general population, especially for smoking- and irradiation-related tumors. Long-term follow-up suggested the importance of smoking cessation and the benefits of counseling cervical cancerpatients accordingly, particularly those who received radiotherapy.
Authors: Gabriella E Puleo; Tia N Borger; Devin Montgomery; Jessica N Rivera Rivera; Jessica L Burris Journal: Psychooncology Date: 2019-11-26 Impact factor: 3.894
Authors: Ryan Suk; Parag Mahale; Kalyani Sonawane; Andrew G Sikora; Jagpreet Chhatwal; Kathleen M Schmeler; Keith Sigel; Scott B Cantor; Elizabeth Y Chiao; Ashish A Deshmukh Journal: JAMA Netw Open Date: 2018-09-07