Clinical characteristics and risk of second primary lung cancer after cervical cancer: A population-based study.

Chengyuan Qian,Mao Nie,Mingfang Xu,Dong Wang,Hong Liu,Shenglan Meng,Yan Feng,Jean-Louis Pujol

doi:10.1371/journal.pone.0231807

Abstract

Lung cancer is increasingly common as a second primary malignancy. However, the clinical characteristics of second primary non-small cell lung cancer after cervical cancer (CC-NSCLC) compared with first primary non-small cell lung cancer (NSCLC1) is unknown. The Surveillance, Epidemiology, and End Results (SEER) cancer registry between 1998 and 2010 was used to conduct a large population-based cohort analysis. The demographic and clinical characteristics, as well as prognostic data, were systematically analyzed. The overall survival (OS) in the two cohorts was further compared. The risk factors of second primary lung cancer in patients with cervical cancer were also analyzed. A total of 557 patients (3.52%) developed second primary lung cancer after cervical cancer, and 451 were eligible for inclusion in the final analyses. Compared with NSCLC1, patients with CC-NSCLC had a higher rate of squamous cell carcinoma (SCC) (36.59% vs 19.07%, P < 0.01). The median OS was longer for CC-NSCLC than for NSCLC1 before propensity score matching (PSM) (16 months vs. 13 months) but with no significant difference after PSM (16 months vs. 17 months). The high-risk factors for the development of cervical cancer to CC-NSCLC include age 50-79 years, black race [odds ratio (OR) 1.417; 95% confidence interval (CI) 1.095-1.834; P < 0.05], and history of radiotherapy (OR 1.392; 95% CI 1.053-1.841; P < 0.05). Age 50-79 years, black race, and history of radiotherapy were independent risk factors for second primary lung cancer in patients with cervical cancer. Patients with CC-NSCLC had distinctive clinical characteristics and better prognosis compared with patients with NSCLC1.

Highlights

Cervical cancer is the fourth most common cancer worldwide, with an estimated 310,000 annual deaths globally [1,2,3]
Compared with NSCLC1, patients with CC-NSCLC had a higher rate of squamous cell carcinoma (SCC) (36.59% vs 19.07%, P < 0.01)
The median overall survival (OS) was longer for CC-NSCLC than for NSCLC1 before propensity score matching (PSM) (16 months vs. 13 months) but with no significant difference after PSM (16 months vs. 17 months)

Summary

Introduction

Cervical cancer is the fourth most common cancer worldwide, with an estimated 310,000 annual deaths globally [1,2,3]. The possibility for patients to develop a subsequent primary cancer becomes a more important consideration [4], with a 17% higher rate of cancer in female patients compared with the general population. Cervical cancer survivors had more than double the rate of lung cancer [5]. As a matter of fact, from 1975 to 2001, 756,467 people in the United States developed a second solid cancer, representing almost 8% of the current cancer survivor population. Subsequent malignancies in cancer survivors constitute 18% of all cancer diagnoses in the US Surveillance, Epidemiology, and End Results (SEER) cancer registries [4]. Lung cancer is increasingly common as a second primary malignancy. The clinical characteristics of second primary non-small cell lung cancer after cervical cancer (CCNSCLC) compared with first primary non-small cell lung cancer (NSCLC1) is unknown

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Conclusion