Abstract
9043 Background: According to the U.S. Surgeon General, cervical cancer is causally linked to smoking tobacco. Persistent smoking among cervical cancer survivors may increase their risk for subsequent malignancies, including tobacco-related cancers. Despite these risks, nearly 40% of the approximately 247,000 women diagnosed with cervical cancer in the U.S. continue to smoke after diagnosis. This study describes the relative risk of developing subsequent malignancies among cervical cancer survivors. Methods: We examined data from 13 Surveillance, Epidemiology and End Results (SEER) registries from 1992-2007. We calculated the relative risk [observed/expected incidence ratios (O/E)] and 95% confidence intervals (CI) for all subsequent and tobacco-related malignancies among cervical cancer survivors. Tobacco-related cancers (lung, pharynx, larynx, esophagus, stomach, pancreas, kidney, bladder, cervix and leukemia) were defined according to the 2004 Surgeon General’s Report on “The Health Consequences of Smoking.” Relative risks for subsequent malignancies were also calculated for female survivors of breast and colorectal cancer for comparison. Results: Overall, the relative risk for diagnosis with a subsequent cancer (excluding non-melanoma skin cancers) was higher among cervical cancer survivors (O/E: 1.4; 95%CI: 1.4-1.5) compared to breast (O/E: 1.2; 95%CI: 1.2-1.2) and colorectal cancer survivors (O/E: 1.2; 95%CI: 1.1-1.2). The relative risk of developing subsequent tobacco-related cancers was also higher among cervical cancer survivors (O/E: 2.3; 95%CI: 2.1-2.5) compared to breast (O/E: 1.0; 95%CI: 1.0-1.1) and colorectal cancer survivors (O/E: 1.1; 95%CI: 1.1-1.2). Conclusions: Women with cervical cancer are at increased risk for subsequent cancers, including tobacco-related cancers, when compared to breast and colorectal cancer survivors. Cervical cancer survivors should be targeted for intervention with evidence-based cancer preventive measures, including increased guidance about smoking-cessation and the availability of cessation treatments.
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