Abstract
The prognosis of malignancies has improved in recent years, subsequent primary cancers (SPCs) have become more frequent. This study investigates the patterns of lung cancer involved multiple primary cancers. We enrolled 206,619 primary lung cancer patients and 2,071,922 patients with other primary malignancies from Surveillance, Epidemiology and End Results (SEER) database. Observed annual risk (OAR) and absolute numbers were used to describe the risk of SPC and observed cases of SPC per 10,000 person-years at risk. Overall, OAR of SPCs following lung cancer was 176.28. At follow-up, 41.26% of SPCs occurred within 12–59 months while the highest OAR appeared after 120 months. The overall OAR of subsequent lung cancer after other malignancies was 27.90. Overall, the highest OAR and the highest absolute numbers of subsequent lung cancers were noticed 60–119 months and over 120 months post-diagnosis, respectively. Ten related cancers were listed. Our findings encourage surveillance for 10 common SPCs in lung cancer survivors during follow-up as well as screening for lung cancer after 10 common malignancies.
Highlights
With the rapid advancements in diagnosis and treatment, the survival times of cancers have become longer in recent years, and subsequent primary cancers (SPCs) have become increasingly common in the investigations of clinical scientists[1,2,3]
The Observed annual risk (OAR), Expected annual risk (EAR), and annual excess risk (AER) of SPCs after lung and bronchus cancer were calculated to explore the patterns of primary lung and bronchus cancer that contributed to the development of other subsequent malignancies
In the current population-based study, we reported the risks of SPCs after lung and bronchus cancer as well as the risks of lung and bronchus cancer after other malignancies
Summary
Excluded cases were those of patients 1) without microscopic confirmation or for whom the report had been obtained solely from a death certificate or autopsy report, 2) whose follow-up time was less than 6 months, and 3) having multiple lung and bronchus cancers. Similar to annual excess risk (AER), which is calculated as the cases (observed–expected) in excess of SPCs per 10,000 person-years at risk (PYR), observed annual risk (OAR) indicates the absolute number of SPCs in patients with a specific primary malignancy per 10,000 PYR12. The OARs, EARs, and AERs of SPCs after lung and bronchus cancer were calculated to explore the patterns of primary lung and bronchus cancer that contributed to the development of other subsequent malignancies. OAR, EAR, AER, and PYR values were calculated using Multiple Primary-Standardized Incidence Ratios (MP-SIR) in SEER*Stat software (Release 8.3.2, 2016; National Cancer Institute Cancer Statistics Branch, Bethesda, MD)
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