Second primary esophageal or lung cancer in patients with head and neck carcinoma in Taiwan: Incidence and risk in relation to primary index tumor site

Min Chi Chen, Ping Tsung Chen, Chunghuang Hubert Chan, Cheng Ta Yang, Chih Cheng Chen, Cih En Huang, Chang Hsien Lu, Kuan Der Lee

Research output: Contribution to journalArticle

21 Citations (Scopus)

Abstract

Background: Second primary cancer is prevalent in patients with head and neck cancer (HNC), for which esophagus and lung are the most usual sites, associated with an extremely poor prognosis. However, information regarding the actual risk of second primary esophageal or lung cancer in South-east Asia, the betel-quid chewing area, has been restricted to data from single-institutions. We have therefore conducted a population-based study to evaluate the incidence, risk, and developmental time of second esophageal or lung cancer in HNC patients. Methods: Standardized incidence ratios (SIRs) and cumulative incidences were calculated for second primary esophageal or lung cancer using a database from the Taiwan Cancer Registry that included 63,720 cases having an initial diagnosis of HNC. Results: The risk of second esophageal cancer was increased in patients with oral/pharyngeal (SIR = 8.71, 95% CI 7.55-10.01) and laryngeal (SIR = 4.65, 95% CI 3.37-6.27) cancers, whereas second lung risk was increased in patients with laryngeal (SIR = 2.05, 95% CI 1.69-2.45) and oral/pharyngeal (SIR = 1.56, 95% CI 1.34-1.80) cancers. The risk excess was prominent for patients with a follow-up interval <5 years and a first primary cancer diagnosed at age <50. Nevertheless, patients with nasopharyngeal carcinoma were not associated with an excess risk in second esophageal or lung cancer. Conclusions: The present dataset provides definite evidence that there is a substantial excess risk of second primary esophageal or lung cancer for the index tumors of oral cavity, pharynx and larynx. The absence of risk excess found in nasopharyngeal carcinoma is also compatible with the existing knowledge that it might have an entirely distinctive etiology.

Original languageEnglish
Pages (from-to)115-123
Number of pages9
JournalJournal of Cancer Research and Clinical Oncology
Volume137
Issue number1
DOIs
Publication statusPublished - Jan 2011
Externally publishedYes

Fingerprint

Second Primary Neoplasms
Esophageal Neoplasms
Taiwan
Lung Neoplasms
Neck
Head
Carcinoma
Incidence
Head and Neck Neoplasms
Neoplasms
Far East
Mastication
Larynx
Pharynx
Registries
Mouth
Databases
Lung

Keywords

  • Betel quid chewing
  • Head and neck cancer
  • Second cancer

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Second primary esophageal or lung cancer in patients with head and neck carcinoma in Taiwan : Incidence and risk in relation to primary index tumor site. / Chen, Min Chi; Chen, Ping Tsung; Chan, Chunghuang Hubert; Yang, Cheng Ta; Chen, Chih Cheng; Huang, Cih En; Lu, Chang Hsien; Lee, Kuan Der.

In: Journal of Cancer Research and Clinical Oncology, Vol. 137, No. 1, 01.2011, p. 115-123.

Research output: Contribution to journalArticle

Chen, Min Chi ; Chen, Ping Tsung ; Chan, Chunghuang Hubert ; Yang, Cheng Ta ; Chen, Chih Cheng ; Huang, Cih En ; Lu, Chang Hsien ; Lee, Kuan Der. / Second primary esophageal or lung cancer in patients with head and neck carcinoma in Taiwan : Incidence and risk in relation to primary index tumor site. In: Journal of Cancer Research and Clinical Oncology. 2011 ; Vol. 137, No. 1. pp. 115-123.
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abstract = "Background: Second primary cancer is prevalent in patients with head and neck cancer (HNC), for which esophagus and lung are the most usual sites, associated with an extremely poor prognosis. However, information regarding the actual risk of second primary esophageal or lung cancer in South-east Asia, the betel-quid chewing area, has been restricted to data from single-institutions. We have therefore conducted a population-based study to evaluate the incidence, risk, and developmental time of second esophageal or lung cancer in HNC patients. Methods: Standardized incidence ratios (SIRs) and cumulative incidences were calculated for second primary esophageal or lung cancer using a database from the Taiwan Cancer Registry that included 63,720 cases having an initial diagnosis of HNC. Results: The risk of second esophageal cancer was increased in patients with oral/pharyngeal (SIR = 8.71, 95{\%} CI 7.55-10.01) and laryngeal (SIR = 4.65, 95{\%} CI 3.37-6.27) cancers, whereas second lung risk was increased in patients with laryngeal (SIR = 2.05, 95{\%} CI 1.69-2.45) and oral/pharyngeal (SIR = 1.56, 95{\%} CI 1.34-1.80) cancers. The risk excess was prominent for patients with a follow-up interval <5 years and a first primary cancer diagnosed at age <50. Nevertheless, patients with nasopharyngeal carcinoma were not associated with an excess risk in second esophageal or lung cancer. Conclusions: The present dataset provides definite evidence that there is a substantial excess risk of second primary esophageal or lung cancer for the index tumors of oral cavity, pharynx and larynx. The absence of risk excess found in nasopharyngeal carcinoma is also compatible with the existing knowledge that it might have an entirely distinctive etiology.",
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T1 - Second primary esophageal or lung cancer in patients with head and neck carcinoma in Taiwan

T2 - Incidence and risk in relation to primary index tumor site

AU - Chen, Min Chi

AU - Chen, Ping Tsung

AU - Chan, Chunghuang Hubert

AU - Yang, Cheng Ta

AU - Chen, Chih Cheng

AU - Huang, Cih En

AU - Lu, Chang Hsien

AU - Lee, Kuan Der

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AB - Background: Second primary cancer is prevalent in patients with head and neck cancer (HNC), for which esophagus and lung are the most usual sites, associated with an extremely poor prognosis. However, information regarding the actual risk of second primary esophageal or lung cancer in South-east Asia, the betel-quid chewing area, has been restricted to data from single-institutions. We have therefore conducted a population-based study to evaluate the incidence, risk, and developmental time of second esophageal or lung cancer in HNC patients. Methods: Standardized incidence ratios (SIRs) and cumulative incidences were calculated for second primary esophageal or lung cancer using a database from the Taiwan Cancer Registry that included 63,720 cases having an initial diagnosis of HNC. Results: The risk of second esophageal cancer was increased in patients with oral/pharyngeal (SIR = 8.71, 95% CI 7.55-10.01) and laryngeal (SIR = 4.65, 95% CI 3.37-6.27) cancers, whereas second lung risk was increased in patients with laryngeal (SIR = 2.05, 95% CI 1.69-2.45) and oral/pharyngeal (SIR = 1.56, 95% CI 1.34-1.80) cancers. The risk excess was prominent for patients with a follow-up interval <5 years and a first primary cancer diagnosed at age <50. Nevertheless, patients with nasopharyngeal carcinoma were not associated with an excess risk in second esophageal or lung cancer. Conclusions: The present dataset provides definite evidence that there is a substantial excess risk of second primary esophageal or lung cancer for the index tumors of oral cavity, pharynx and larynx. The absence of risk excess found in nasopharyngeal carcinoma is also compatible with the existing knowledge that it might have an entirely distinctive etiology.

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