Abstract
BackgroundCancer survivors face an increased likelihood of being subsequently diagnosed with another cancer. The aim of this study was to quantify the relative risk of survivors developing a second primary cancer in Queensland, Australia.MethodsStandardised incidence rates stratified by type of first primary cancer, type of second primary cancer, sex, age at first diagnosis, period of first diagnosis and follow-up interval were calculated for residents of Queensland, Australia, who were diagnosed with a first primary invasive cancer between 1982 and 2001 and survived for a minimum of 2 months.ResultsA total of 23,580 second invasive primary cancers were observed over 1,370,247 years of follow-up among 204,962 cancer patients. Both males (SIR = 1.22; 95% CI = 1.20-1.24) and females (SIR = 1.36; 95% CI = 1.33-1.39) within the study cohort were found to have a significant excess risk of developing a second cancer relative to the incidence of cancer in the general population. The observed number of second primary cancers was also higher than expected within each age group, across all time periods and during each follow-up interval.ConclusionsThe excess risk of developing a second malignancy among cancer survivors can likely be attributed to factors including similar aetiologies, genetics and the effects of treatment, underlining the need for ongoing monitoring of cancer patients to detect subsequent tumours at an early stage. Education campaigns developed specifically for survivors may be required to lessen the prevalence of known cancer risk factors.
Highlights
Cancer survivors face an increased likelihood of being subsequently diagnosed with another cancer
This study reports for the first time the relative risks of a second cancer for people diagnosed with a first primary cancer in Queensland, Australia
Relative risk of second primary cancers by sex Compared to the incidence of cancer in the general Queensland population, both males (SIR = 1.22; 95% Confidence intervals (CIs) = 1.20-1.24) and females (SIR = 1.36; 95% CI = 1.331.39) in the study cohort exhibited an increased risk of developing a second primary cancer (Table 2)
Summary
Cancer survivors face an increased likelihood of being subsequently diagnosed with another cancer. The aim of this study was to quantify the relative risk of survivors developing a second primary cancer in Queensland, Australia. The number of people being diagnosed with cancer worldwide is rising sharply, mainly as a result of population growth, ageing and increases in the prevalence of several lifestyle factors related to cancer risk [1,2]. One of the consequences of surviving cancer is the increased likelihood of being diagnosed with a second primary cancer. Among other things, these second cancers may be the result of lifestyle choices, genetics, environmental exposures (all of which may be related to the first cancer) and late effects of treatment [3,4]. Identifying cancers which have an elevated likelihood of occurring together is a useful starting point for investigating possible shared aetiologies and mechanisms of carcinogenesis [7]
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