Abstract
PurposeThe rising incidence and life expectancy associated with prostate cancer (PCa) has led to increasing interest in predicting the risk of second primary malignancies (SPMs) among PCa survivors, although data regarding SPMs after PCa are controversial.MethodsWe identified 30,964 patients from the National Health Insurance Research Database in Taiwan who had newly diagnosed PCa between 2000 and 2010. Each patient was randomly frequency-matched with an individual without PCa, based on age, comorbidity, and index year. Competing-risks regression models were used to estimate subhazard ratios (SHRs) of SPMs development associated with PCa. The Bonferroni adjustment was used in multiple comparisons.ResultsMen with PCa had a trend of lower risk of developing overall SPMs compared to those without PCa (adjusted SHR = 0.94, 99.72% confidence interval [CI] = 0.89–1.00, p = 0.06). The risks of lung and liver cancer were significantly lower. In contrast, these patients had a significantly higher risk of thyroid cancer. There is a trend for a higher risk of developing SPMs in the urinary bladder and rectum/anus. Further analyses indicated that PCa patients who received radiation therapy (RT) had an increased risk of overall SPMs, hematologic malignancies, esophageal cancer, liver cancer, lung cancer, and urinary bladder cancer compared with those who did not receive RT.ConclusionMen with PCa tended to have a lower risk of SPMs, but a significantly higher risk of subsequent thyroid cancer. Continued cancer surveillance is required among PCa survivors, especially in specific sites and in individuals who received RT.
Highlights
Prostate cancer (PCa) is the second most common cancer worldwide in men, with an incidence of 31.1 per 100,000 [1]
Men with PCa had a trend of lower risk of developing overall second primary malignancies (SPMs) compared to those without PCa
There is a trend for a higher risk of developing SPMs in the urinary bladder and rectum/anus
Summary
Prostate cancer (PCa) is the second most common cancer worldwide in men, with an incidence of 31.1 per 100,000 [1]. The increase may result from the widespread adoption of serum prostate-specific antigen (PSA) screening, which has led to potential reductions in advanced disease and PCa-specific mortality [6]. This technique, combined with advances in surgery, radiation therapy (RT), and androgen deprivation therapy (ADT), have led to increased survival of PCa patients, with current estimates of 10-year and 15-year relative survival at 98% and 91%, respectively [7]. Given the increases in incidence and the life expectancy of PCa patients, there is growing interest in predicting the risk of second primary malignancies (SPMs) among PCa survivors
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