The incidence and risk of developing a second primary esophageal cancer in patients with oral and pharyngeal carcinoma: A population-based study in Taiwan over a 25 year period

Kuan Der Lee, Chang Hsien Lu, Ping Tsung Chen, Chunghuang H. Chan, Jen Tsun Lin, Cih En Huang, Chih Cheng Chen, Min Chi Chen

Research output: Contribution to journalArticle

31 Citations (Scopus)

Abstract

Background: The incidence of oral and pharyngeal (including oral cavity, oropharynx and hypopharynx) carcinoma increases rapidly in Asia and South Pacific because of betel quid chewing. Thus far, large-scale epidemiological studies are not available yet to stratify these patients by their risks of developing a second primary cancer in the digestive tract including esophagus, stomach, colon, and rectum. Methods: A population-based study was conducted using the database from the Taiwan National Cancer Registry for the period 1979-2003. We quantified standardized incidence ratios (SIRs) and cumulative incidence of second primary cancers among 33,787 patients with initial diagnoses of oral and pharyngeal carcinoma. Results: Among these four digestive tract organs, the esophagus was the only site of second cancer with excess risk in patients with oral and pharyngeal carcinoma. The incidence and risk of developing a second primary esophageal cancer differed by the site of the primary index tumor, most frequently seen in hypopharyngeal cancer (71/4,218 = 1.68%, SIR = 22.76, 95% CI 17.77-28.70), followed by oropharyngeal cancer (30/3,403 = 0.88%, SIR = 14.29, 95% CI 9.64-20.39) and the least in oral cavity cancer (99/26,166 = 0.38%, SIR = 5.57, 95% CI 4.53-6.78). In addition, the risk was extraordinarily high for patients with a follow-up interval ≤ 1 year and those with first primary cancer diagnosed at age ≤50. These patients may justify more close surveillance. Conclusion: The present study represents the first population-based study in Asia attempting to stratify the patients of oral and pharyngeal carcinoma by their risk of developing a second esophageal cancer. It helps identify patients at high risk and tailor the application of intense follow-up surveillance to the estimated risk in each individual case.

Original languageEnglish
Article number1471
Number of pages1
JournalBMC Cancer
Volume9
DOIs
Publication statusPublished - Oct 20 2009
Externally publishedYes

Fingerprint

Second Primary Neoplasms
Esophageal Neoplasms
Taiwan
Carcinoma
Incidence
Population
Esophagus
Mouth
Gastrointestinal Tract
Hypopharyngeal Neoplasms
Oropharyngeal Neoplasms
Oral Diagnosis
Hypopharynx
Neoplasms
Oropharynx
Mouth Neoplasms
Mastication
Rectum
Registries
Epidemiologic Studies

ASJC Scopus subject areas

  • Oncology
  • Genetics
  • Cancer Research

Cite this

The incidence and risk of developing a second primary esophageal cancer in patients with oral and pharyngeal carcinoma : A population-based study in Taiwan over a 25 year period. / Lee, Kuan Der; Lu, Chang Hsien; Chen, Ping Tsung; Chan, Chunghuang H.; Lin, Jen Tsun; Huang, Cih En; Chen, Chih Cheng; Chen, Min Chi.

In: BMC Cancer, Vol. 9, 1471, 20.10.2009.

Research output: Contribution to journalArticle

Lee, Kuan Der ; Lu, Chang Hsien ; Chen, Ping Tsung ; Chan, Chunghuang H. ; Lin, Jen Tsun ; Huang, Cih En ; Chen, Chih Cheng ; Chen, Min Chi. / The incidence and risk of developing a second primary esophageal cancer in patients with oral and pharyngeal carcinoma : A population-based study in Taiwan over a 25 year period. In: BMC Cancer. 2009 ; Vol. 9.
@article{f886c1c90933401f843c7df9ca7da5cb,
title = "The incidence and risk of developing a second primary esophageal cancer in patients with oral and pharyngeal carcinoma: A population-based study in Taiwan over a 25 year period",
abstract = "Background: The incidence of oral and pharyngeal (including oral cavity, oropharynx and hypopharynx) carcinoma increases rapidly in Asia and South Pacific because of betel quid chewing. Thus far, large-scale epidemiological studies are not available yet to stratify these patients by their risks of developing a second primary cancer in the digestive tract including esophagus, stomach, colon, and rectum. Methods: A population-based study was conducted using the database from the Taiwan National Cancer Registry for the period 1979-2003. We quantified standardized incidence ratios (SIRs) and cumulative incidence of second primary cancers among 33,787 patients with initial diagnoses of oral and pharyngeal carcinoma. Results: Among these four digestive tract organs, the esophagus was the only site of second cancer with excess risk in patients with oral and pharyngeal carcinoma. The incidence and risk of developing a second primary esophageal cancer differed by the site of the primary index tumor, most frequently seen in hypopharyngeal cancer (71/4,218 = 1.68{\%}, SIR = 22.76, 95{\%} CI 17.77-28.70), followed by oropharyngeal cancer (30/3,403 = 0.88{\%}, SIR = 14.29, 95{\%} CI 9.64-20.39) and the least in oral cavity cancer (99/26,166 = 0.38{\%}, SIR = 5.57, 95{\%} CI 4.53-6.78). In addition, the risk was extraordinarily high for patients with a follow-up interval ≤ 1 year and those with first primary cancer diagnosed at age ≤50. These patients may justify more close surveillance. Conclusion: The present study represents the first population-based study in Asia attempting to stratify the patients of oral and pharyngeal carcinoma by their risk of developing a second esophageal cancer. It helps identify patients at high risk and tailor the application of intense follow-up surveillance to the estimated risk in each individual case.",
author = "Lee, {Kuan Der} and Lu, {Chang Hsien} and Chen, {Ping Tsung} and Chan, {Chunghuang H.} and Lin, {Jen Tsun} and Huang, {Cih En} and Chen, {Chih Cheng} and Chen, {Min Chi}",
year = "2009",
month = "10",
day = "20",
doi = "10.1186/1471-2407-9-373",
language = "English",
volume = "9",
journal = "BMC Cancer",
issn = "1471-2407",
publisher = "BioMed Central",

}

TY - JOUR

T1 - The incidence and risk of developing a second primary esophageal cancer in patients with oral and pharyngeal carcinoma

T2 - A population-based study in Taiwan over a 25 year period

AU - Lee, Kuan Der

AU - Lu, Chang Hsien

AU - Chen, Ping Tsung

AU - Chan, Chunghuang H.

AU - Lin, Jen Tsun

AU - Huang, Cih En

AU - Chen, Chih Cheng

AU - Chen, Min Chi

PY - 2009/10/20

Y1 - 2009/10/20

N2 - Background: The incidence of oral and pharyngeal (including oral cavity, oropharynx and hypopharynx) carcinoma increases rapidly in Asia and South Pacific because of betel quid chewing. Thus far, large-scale epidemiological studies are not available yet to stratify these patients by their risks of developing a second primary cancer in the digestive tract including esophagus, stomach, colon, and rectum. Methods: A population-based study was conducted using the database from the Taiwan National Cancer Registry for the period 1979-2003. We quantified standardized incidence ratios (SIRs) and cumulative incidence of second primary cancers among 33,787 patients with initial diagnoses of oral and pharyngeal carcinoma. Results: Among these four digestive tract organs, the esophagus was the only site of second cancer with excess risk in patients with oral and pharyngeal carcinoma. The incidence and risk of developing a second primary esophageal cancer differed by the site of the primary index tumor, most frequently seen in hypopharyngeal cancer (71/4,218 = 1.68%, SIR = 22.76, 95% CI 17.77-28.70), followed by oropharyngeal cancer (30/3,403 = 0.88%, SIR = 14.29, 95% CI 9.64-20.39) and the least in oral cavity cancer (99/26,166 = 0.38%, SIR = 5.57, 95% CI 4.53-6.78). In addition, the risk was extraordinarily high for patients with a follow-up interval ≤ 1 year and those with first primary cancer diagnosed at age ≤50. These patients may justify more close surveillance. Conclusion: The present study represents the first population-based study in Asia attempting to stratify the patients of oral and pharyngeal carcinoma by their risk of developing a second esophageal cancer. It helps identify patients at high risk and tailor the application of intense follow-up surveillance to the estimated risk in each individual case.

AB - Background: The incidence of oral and pharyngeal (including oral cavity, oropharynx and hypopharynx) carcinoma increases rapidly in Asia and South Pacific because of betel quid chewing. Thus far, large-scale epidemiological studies are not available yet to stratify these patients by their risks of developing a second primary cancer in the digestive tract including esophagus, stomach, colon, and rectum. Methods: A population-based study was conducted using the database from the Taiwan National Cancer Registry for the period 1979-2003. We quantified standardized incidence ratios (SIRs) and cumulative incidence of second primary cancers among 33,787 patients with initial diagnoses of oral and pharyngeal carcinoma. Results: Among these four digestive tract organs, the esophagus was the only site of second cancer with excess risk in patients with oral and pharyngeal carcinoma. The incidence and risk of developing a second primary esophageal cancer differed by the site of the primary index tumor, most frequently seen in hypopharyngeal cancer (71/4,218 = 1.68%, SIR = 22.76, 95% CI 17.77-28.70), followed by oropharyngeal cancer (30/3,403 = 0.88%, SIR = 14.29, 95% CI 9.64-20.39) and the least in oral cavity cancer (99/26,166 = 0.38%, SIR = 5.57, 95% CI 4.53-6.78). In addition, the risk was extraordinarily high for patients with a follow-up interval ≤ 1 year and those with first primary cancer diagnosed at age ≤50. These patients may justify more close surveillance. Conclusion: The present study represents the first population-based study in Asia attempting to stratify the patients of oral and pharyngeal carcinoma by their risk of developing a second esophageal cancer. It helps identify patients at high risk and tailor the application of intense follow-up surveillance to the estimated risk in each individual case.

UR - http://www.scopus.com/inward/record.url?scp=70450263383&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=70450263383&partnerID=8YFLogxK

U2 - 10.1186/1471-2407-9-373

DO - 10.1186/1471-2407-9-373

M3 - Article

C2 - 19843324

AN - SCOPUS:70450263383

VL - 9

JO - BMC Cancer

JF - BMC Cancer

SN - 1471-2407

M1 - 1471

ER -