Incidence and patterns of second primary malignancies following oral cavity cancers in a prevalent area of betel-nut chewing: A population-based cohort of 26 166 patients in Taiwan

Ping Tsung Chen, Feng Che Kuan, Cih En Huang, Miao Fen Chen, Shih How Huang, Min Chi Chen, Kuan Der Lee

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

Objective: The incidence of oral cavity cancers is increasing rapidly in South-East Asia, which may be attributable to tobacco smoking, alcohol and betel-nut chewing. However, the actual incidence and risk of second primary malignancies after oral cavity cancers have not been well established in this region. A population-based study was therefore conducted. Methods: Standardized incidence ratios and cumulative incidences were calculated for second primary cancers using the Taiwan Cancer Registry database for the period 1979-2003, which included 26 166 cases having an initial diagnosis of oral cavity cancers. Results: A 3.11-fold increase in risk for second cancer at all sites was observed after oral cavity cancers compared with the general population (standardized incidence ratio = 3.11, 95% confidence interval: 2.97-3.25). Of nine sites with excess risks of developing a second cancer, the frequency was highest in the oral/pharynx (60%), followed by lung (7.2%) and esophagus (5.5%). Second esophageal and lung cancers had a greater impact on survival compared with other types of second cancer. Notably, the risk excess was more prominent for patients with a follow-up interval of ≤1 year and a first primary cancer diagnosed at age of ≤40. These patients may justify closer surveillance. Conclusions: This is the largest population-based study with a homogeneous patient population focusing on oral cavity cancers within a high-incidence area. We found that oral cavity cancers are associated with an increased risk of nine second malignancies, which had a negative impact on survival.

Original languageEnglish
Article numberhyr152
Pages (from-to)1336-1343
Number of pages8
JournalJapanese Journal of Clinical Oncology
Volume41
Issue number12
DOIs
Publication statusPublished - Dec 2011
Externally publishedYes

Fingerprint

Areca
Second Primary Neoplasms
Mouth Neoplasms
Mastication
Taiwan
Mouth
Incidence
Population
Survival
Far East
Esophageal Neoplasms
Pharynx
Esophagus
Registries
Lung Neoplasms
Neoplasms
Smoking
Alcohols
Databases
Confidence Intervals

Keywords

  • Betel-nut chewing
  • Oral cavity cancers
  • Second cancer

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Cancer Research

Cite this

Incidence and patterns of second primary malignancies following oral cavity cancers in a prevalent area of betel-nut chewing : A population-based cohort of 26 166 patients in Taiwan. / Chen, Ping Tsung; Kuan, Feng Che; Huang, Cih En; Chen, Miao Fen; Huang, Shih How; Chen, Min Chi; Lee, Kuan Der.

In: Japanese Journal of Clinical Oncology, Vol. 41, No. 12, hyr152, 12.2011, p. 1336-1343.

Research output: Contribution to journalArticle

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abstract = "Objective: The incidence of oral cavity cancers is increasing rapidly in South-East Asia, which may be attributable to tobacco smoking, alcohol and betel-nut chewing. However, the actual incidence and risk of second primary malignancies after oral cavity cancers have not been well established in this region. A population-based study was therefore conducted. Methods: Standardized incidence ratios and cumulative incidences were calculated for second primary cancers using the Taiwan Cancer Registry database for the period 1979-2003, which included 26 166 cases having an initial diagnosis of oral cavity cancers. Results: A 3.11-fold increase in risk for second cancer at all sites was observed after oral cavity cancers compared with the general population (standardized incidence ratio = 3.11, 95{\%} confidence interval: 2.97-3.25). Of nine sites with excess risks of developing a second cancer, the frequency was highest in the oral/pharynx (60{\%}), followed by lung (7.2{\%}) and esophagus (5.5{\%}). Second esophageal and lung cancers had a greater impact on survival compared with other types of second cancer. Notably, the risk excess was more prominent for patients with a follow-up interval of ≤1 year and a first primary cancer diagnosed at age of ≤40. These patients may justify closer surveillance. Conclusions: This is the largest population-based study with a homogeneous patient population focusing on oral cavity cancers within a high-incidence area. We found that oral cavity cancers are associated with an increased risk of nine second malignancies, which had a negative impact on survival.",
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