Abstract
BackgroundMore people than ever before are currently living with a diagnosis of cancer and the number of people concerned is likely to continue to rise. Cancer survivors are at risk of developing a second primary cancer (SPC). This study aims to investigate the risk of SPC in Switzerland.MethodsThe study cohort included all patients with a first primary cancer recorded in 9 Swiss population-based cancer registries 1981–2009 who had a minimum survival of 6 months, and a potential follow-up until the end of 2014. We calculated standardized incidence ratios (SIR) to estimate relative risks (RR) of SPC in cancer survivors compared with the cancer risk of the general population. SIR were stratified by type of first cancer, sex, age and period of first diagnosis, survival period and site of SPC.ResultsA total of 33,793 SPC were observed in 310,113 cancer patients. Both male (SIR 1.18, 95%CI 1.16–1.19) and female (SIR 1.20, 95%CI 1.18–1.22) cancer survivors had an elevated risk of developing a SPC. Risk estimates varied substantially according to type of first cancer and were highest in patients initially diagnosed with cancer of the oral cavity and pharynx, Hodgkin lymphoma, laryngeal, oesophageal, or lung cancer. Age-stratified analyses revealed a tendency towards higher RR in patients first diagnosed at younger ages. Stratified by survival period, risk estimates showed a rising trend with increasing time from the initial diagnosis. We observed strong associations between particular types of first and SPC, i.e. cancer types sharing common risk factors such as smoking or alcohol consumption (e.g. repeated cancer of the oral cavity and pharynx (SIRmales 20.12, 95%CI 17.91–22.33; SIRfemales 37.87, 95%CI 30.27–45.48).ConclusionSwiss cancer survivors have an increased risk of developing a SPC compared to the general population, particularly patients first diagnosed before age 50 and those surviving more than 10 years. Cancer patients should remain under continued surveillance not only for recurrent cancers but also for new cancers. Some first and SPCs share lifestyle associated risk factors making it important to promote healthier lifestyles in both the general population and cancer survivors.
Highlights
More people than ever before are currently living with a diagnosis of cancer and the number of people concerned is likely to continue to rise
Risk estimates varied substantially according to type of first cancer and were highest in patients initially diagnosed with cancer of the oral cavity and pharynx, Hodgkin lymphoma, laryngeal, oesophageal, or lung cancer
Swiss cancer survivors have an increased risk of developing a second primary cancer (SPC) compared to the general population, patients first diagnosed before age 50 and those surviving more than 10 years
Summary
More people than ever before are currently living with a diagnosis of cancer and the number of people concerned is likely to continue to rise. Cancer survivors are at risk of developing a second primary cancer (SPC). Apart from total population growth [5], this trend results from an increase in life expectancy [6], population ageing [5], and continuing improvements in survival linked to better cancer detection and improvement of treatments [7, 8]. A consequence of surviving cancer is the risk of being diagnosed with a second primary cancer (SPC). Cancer survivors might be especially prone to develop a new primary cancer due to various reasons including common etiologic risk factors (i.e. environmental exposures, genetics, lifestyle choices) and late effects of cancer treatment [9]. SPC is a difficult event for patients but could be an important prognostic factor among cancer survivors [10]
Sign-in/Register to view highlights & summary 
Published Version (
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 callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
