Risk of second primary malignancies in women with cervical cancer: A population-based study in Taiwan over a 30-year period

Chao Yu Chen, Chyong Huey Lai, Kuan Der Lee, Shih Hao Huang, Yen Mei Dai, Min Chi Chen

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

Objective: Studies conducted in Western countries have reported an increased risk for second primary malignancies after cervical cancer. There is little documentation of ethnic differences in this increased risk, and most of the Asian studies are hospital-based studies with small case numbers. Methods: Using population-based data from the Taiwan Cancer Registry for the period 1979-2008, we quantified standardized incidence ratios (SIRs) among 52,972 women with initial diagnoses of cervical cancer. Results: Among the 52,972 women, 3061 (5.78%) developed second primary cancers during 433,571 person-years of follow-up. Overall, the SIR for developing a subsequent second cancer was significantly greater than that of the general population (1.36 [95% CI, 1.32-1.41]). There was a greater risk for cancers of the esophagus, stomach, small intestine, rectum, lung, bone, non-melanoma skin, uterine corpus, vagina/vulva, bladder, kidney, and leukemia. When further examining age at diagnosis of cervical cancer (< 50 and ≥ 50) for these 12 sites, we found that the risk of second cancers (SIR, < 50 and ≥ 50: 3.08 vs. 1.63) was higher not only in younger patients, except for non-melanoma skin cancer and endometrial cancer, but also within the first 5 years after diagnosis of cervical cancer. The median overall survival for women with cervical cancer was 18.58 years. The second cancers had a negative impact on overall survival after adjusting for age (P < 0.001). Conclusions: SIR for second cancers was significantly greater than the general population in cervical cancer patients. A young age at the diagnosis of cervical cancer predicted an increased risk. The second cancers worsened overall survival.

Original languageEnglish
Pages (from-to)625-630
Number of pages6
JournalGynecologic Oncology
Volume127
Issue number3
DOIs
Publication statusPublished - Dec 2012
Externally publishedYes

Fingerprint

Second Primary Neoplasms
Taiwan
Uterine Cervical Neoplasms
Population
Incidence
Survival
Vulva
Skin Neoplasms
Vagina
Endometrial Neoplasms
Esophageal Neoplasms
Rectum
Documentation
Small Intestine
Stomach Neoplasms
Registries
Leukemia
Urinary Bladder
Kidney
Bone and Bones

Keywords

  • Cervical cancer
  • Second primary malignancy
  • Standardized incidence ratios
  • Taiwan Cancer Registry

ASJC Scopus subject areas

  • Obstetrics and Gynaecology
  • Oncology

Cite this

Risk of second primary malignancies in women with cervical cancer : A population-based study in Taiwan over a 30-year period. / Chen, Chao Yu; Lai, Chyong Huey; Lee, Kuan Der; Huang, Shih Hao; Dai, Yen Mei; Chen, Min Chi.

In: Gynecologic Oncology, Vol. 127, No. 3, 12.2012, p. 625-630.

Research output: Contribution to journalArticle

Chen, Chao Yu ; Lai, Chyong Huey ; Lee, Kuan Der ; Huang, Shih Hao ; Dai, Yen Mei ; Chen, Min Chi. / Risk of second primary malignancies in women with cervical cancer : A population-based study in Taiwan over a 30-year period. In: Gynecologic Oncology. 2012 ; Vol. 127, No. 3. pp. 625-630.
@article{7eb9592b8ede4db885c6c6bbaf44a0e9,
title = "Risk of second primary malignancies in women with cervical cancer: A population-based study in Taiwan over a 30-year period",
abstract = "Objective: Studies conducted in Western countries have reported an increased risk for second primary malignancies after cervical cancer. There is little documentation of ethnic differences in this increased risk, and most of the Asian studies are hospital-based studies with small case numbers. Methods: Using population-based data from the Taiwan Cancer Registry for the period 1979-2008, we quantified standardized incidence ratios (SIRs) among 52,972 women with initial diagnoses of cervical cancer. Results: Among the 52,972 women, 3061 (5.78{\%}) developed second primary cancers during 433,571 person-years of follow-up. Overall, the SIR for developing a subsequent second cancer was significantly greater than that of the general population (1.36 [95{\%} CI, 1.32-1.41]). There was a greater risk for cancers of the esophagus, stomach, small intestine, rectum, lung, bone, non-melanoma skin, uterine corpus, vagina/vulva, bladder, kidney, and leukemia. When further examining age at diagnosis of cervical cancer (< 50 and ≥ 50) for these 12 sites, we found that the risk of second cancers (SIR, < 50 and ≥ 50: 3.08 vs. 1.63) was higher not only in younger patients, except for non-melanoma skin cancer and endometrial cancer, but also within the first 5 years after diagnosis of cervical cancer. The median overall survival for women with cervical cancer was 18.58 years. The second cancers had a negative impact on overall survival after adjusting for age (P < 0.001). Conclusions: SIR for second cancers was significantly greater than the general population in cervical cancer patients. A young age at the diagnosis of cervical cancer predicted an increased risk. The second cancers worsened overall survival.",
keywords = "Cervical cancer, Second primary malignancy, Standardized incidence ratios, Taiwan Cancer Registry",
author = "Chen, {Chao Yu} and Lai, {Chyong Huey} and Lee, {Kuan Der} and Huang, {Shih Hao} and Dai, {Yen Mei} and Chen, {Min Chi}",
year = "2012",
month = "12",
doi = "10.1016/j.ygyno.2012.09.004",
language = "English",
volume = "127",
pages = "625--630",
journal = "Gynecologic Oncology",
issn = "0090-8258",
publisher = "Elsevier",
number = "3",

}

TY - JOUR

T1 - Risk of second primary malignancies in women with cervical cancer

T2 - A population-based study in Taiwan over a 30-year period

AU - Chen, Chao Yu

AU - Lai, Chyong Huey

AU - Lee, Kuan Der

AU - Huang, Shih Hao

AU - Dai, Yen Mei

AU - Chen, Min Chi

PY - 2012/12

Y1 - 2012/12

N2 - Objective: Studies conducted in Western countries have reported an increased risk for second primary malignancies after cervical cancer. There is little documentation of ethnic differences in this increased risk, and most of the Asian studies are hospital-based studies with small case numbers. Methods: Using population-based data from the Taiwan Cancer Registry for the period 1979-2008, we quantified standardized incidence ratios (SIRs) among 52,972 women with initial diagnoses of cervical cancer. Results: Among the 52,972 women, 3061 (5.78%) developed second primary cancers during 433,571 person-years of follow-up. Overall, the SIR for developing a subsequent second cancer was significantly greater than that of the general population (1.36 [95% CI, 1.32-1.41]). There was a greater risk for cancers of the esophagus, stomach, small intestine, rectum, lung, bone, non-melanoma skin, uterine corpus, vagina/vulva, bladder, kidney, and leukemia. When further examining age at diagnosis of cervical cancer (< 50 and ≥ 50) for these 12 sites, we found that the risk of second cancers (SIR, < 50 and ≥ 50: 3.08 vs. 1.63) was higher not only in younger patients, except for non-melanoma skin cancer and endometrial cancer, but also within the first 5 years after diagnosis of cervical cancer. The median overall survival for women with cervical cancer was 18.58 years. The second cancers had a negative impact on overall survival after adjusting for age (P < 0.001). Conclusions: SIR for second cancers was significantly greater than the general population in cervical cancer patients. A young age at the diagnosis of cervical cancer predicted an increased risk. The second cancers worsened overall survival.

AB - Objective: Studies conducted in Western countries have reported an increased risk for second primary malignancies after cervical cancer. There is little documentation of ethnic differences in this increased risk, and most of the Asian studies are hospital-based studies with small case numbers. Methods: Using population-based data from the Taiwan Cancer Registry for the period 1979-2008, we quantified standardized incidence ratios (SIRs) among 52,972 women with initial diagnoses of cervical cancer. Results: Among the 52,972 women, 3061 (5.78%) developed second primary cancers during 433,571 person-years of follow-up. Overall, the SIR for developing a subsequent second cancer was significantly greater than that of the general population (1.36 [95% CI, 1.32-1.41]). There was a greater risk for cancers of the esophagus, stomach, small intestine, rectum, lung, bone, non-melanoma skin, uterine corpus, vagina/vulva, bladder, kidney, and leukemia. When further examining age at diagnosis of cervical cancer (< 50 and ≥ 50) for these 12 sites, we found that the risk of second cancers (SIR, < 50 and ≥ 50: 3.08 vs. 1.63) was higher not only in younger patients, except for non-melanoma skin cancer and endometrial cancer, but also within the first 5 years after diagnosis of cervical cancer. The median overall survival for women with cervical cancer was 18.58 years. The second cancers had a negative impact on overall survival after adjusting for age (P < 0.001). Conclusions: SIR for second cancers was significantly greater than the general population in cervical cancer patients. A young age at the diagnosis of cervical cancer predicted an increased risk. The second cancers worsened overall survival.

KW - Cervical cancer

KW - Second primary malignancy

KW - Standardized incidence ratios

KW - Taiwan Cancer Registry

UR - http://www.scopus.com/inward/record.url?scp=84868575231&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84868575231&partnerID=8YFLogxK

U2 - 10.1016/j.ygyno.2012.09.004

DO - 10.1016/j.ygyno.2012.09.004

M3 - Article

C2 - 22975362

AN - SCOPUS:84868575231

VL - 127

SP - 625

EP - 630

JO - Gynecologic Oncology

JF - Gynecologic Oncology

SN - 0090-8258

IS - 3

ER -