Abstract
BackgroundPrevious studies assessing second primary malignancies (SPMs) after uterine cancer have been conducted in Western populations with conflicting results. This study aimed to define the incidence and risk of SPMs in Taiwanese patients with an initial diagnosis of uterine cancer.MethodsUsing population-based data from the Taiwan Cancer Registry for the period 1979–2008, we quantified standardized incidence ratios (SIRs) among 11,571 women with an initial diagnosis of uterine cancer.ResultsAmong the 11,571 women, 555 (4.80 %) developed at least one SPM during 69,987 person-years of follow-up. There was a 71 % increased risk of SPM following uterine cancer (SIR = 1.71, 95 % CI, 1.57–1.86), with higher risks in the vagina/vulva (SIR = 9.06), small intestine (SIR = 8.45), ovary (SIR = 4.15), urinary bladder (SIR = 2.31), kidney (SIR = 2.24), colorectum (SIR = 2.24), lung (SIR = 1.96), and breast (SIR = 1.43). The risk of SPM was found to be the highest within the first 5 years after diagnosis of uterine cancer, with surveillance bias possibly contributing to the extremely high risk observed in the first follow-up year. The overall risk and pattern of SPM development observed in this study differed from those previously reported in Western populations, possibly because of the methodology and shorter follow-up period employed in this study. The cumulative incidence of SPMs was significantly higher in older patients (≥50 years) than in younger patients (P < 0.001).ConclusionsTo our knowledge, this is the first study in an Asian population to report 71 % increased risk in SPMs in women previously diagnosed with uterine cancer. A younger age at diagnosis of uterine cancer conferred an increased risk of second malignancies, and SPMs worsened survivorship in patients who survived uterine cancer.
Highlights
Previous studies assessing second primary malignancies (SPMs) after uterine cancer have been conducted in Western populations with conflicting results
Uterine cancer was diagnosed at a mean age of 52.93 years, and the mean age at SPM diagnosis was 61.23 years
Risk of second primary malignancies stratified by site Standardized incidence ratio (SIR) and the corresponding 95 % Confidence interval (CI) for SPMs at all sites, except the uterine corpus, were calculated
Summary
Previous studies assessing second primary malignancies (SPMs) after uterine cancer have been conducted in Western populations with conflicting results. This study aimed to define the incidence and risk of SPMs in Taiwanese patients with an initial diagnosis of uterine cancer. The 5-year overall survival rate for uterine cancers recorded in the Surveillance, Epidemiology, and End Results (SEER) database (1988–2001) was found to be 87.9 %. Considering the increasing incidence and survival rate of patients with uterine cancer worldwide, SPMs have become an increasingly important clinical issue. Two large SEER studies based on 90,502 and 98,205 patients with primary endometrial cancer from 1973–2004 and 1973–2007, respectively, revealed that the overall risk of SPMs did not differ from the general population [14, 18]. A nationwide Swedish population-based study reported a 54 % increased risk in overall SPMs [13], and other studies have reported a higher risk of developing SPMs after uterine cancers in patients with a young age at diagnosis [17], African ancestry [18], Lynch syndrome (LS), family history of breast or ovarian cancer [12, 13, 17], and in those receiving radiotherapy [15, 16]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
