Incidence of second malignancies among 10,919 patients over 20 years: Retrospective analysis of a community hospital cancer registry data.

Abstract

e12026 Background: Diagnosis of a second cancer contributes significantly to subsequent morbidity and mortality in cancer survivors. The aim of this study is to ascertain the incidence and characteristics of second cancers among adult patients enrolled in the Hurley Medical Center cancer registry. Methods: The registry was searched for patients enrolled during 1988-2007, who were diagnosed with subsequent cancers. Incidence and survival was analysed. Results: Total follow up was for over 78,680 person-years. 700 patients (6.4%) had subsequent cancers over 20 years, compared to SEER results of 13.7% over 20 years. Further analyses were performed on 534 patients (76%) for whom detailed data was available. Incidence rate of second cancers was 0.6% per year of follow up. About 25 second cancers were diagnosed annually, making up 5% of the ∼550 new diagnoses, compared to 16% in SEER data. Median interval between the diagnoses of the two cancers was 32 months. Among second cancer sites, breast (20%), lung (17%) head and neck (7.5%), colorectal (7.1%) and prostate (6.9%) were most frequent. In comparison, commonest second sites described in the SEER report are: lung (17.3%), breast (16.4%), colon (11.1%), prostate (10%) and head and neck (4.8%). 242 (45.3%) of the patients were male, and 292 (54.7%) were female. Mean age at diagnosis of the first cancer was 62 years and second cancer was 65 years. Median survival duration was 82 months after first cancer and 33 months after the second. After a median of 10 years of follow up, 192 (36%) were alive. In the SEER analysis, 20% survived to 10 years. Analysis of causes of death showed that 41 were directly and 9 were indirectly related to the cancer. This information was unavailable for 258 patients (75%). Conclusions: Compared to SEER data, recorded incidences of second cancers are lower in our cancer registry, and survival proportion at 10 years is higher. Incomplete follow up due to out-migration of patients may have contributed to low incidence. Second cancers may be related to common risk factors and some are detectable by age-appropriate screening programs. Hence it is important to emphasize lifestyle modifications and cancer surveillance among cancer survivors. No significant financial relationships to disclose.