Journal of Cancer Research and Clinical Oncology

, Volume 137, Issue 1, pp 115–123

Second primary esophageal or lung cancer in patients with head and neck carcinoma in Taiwan: incidence and risk in relation to primary index tumor site

  • Min-Chi Chen
  • Ping-Tsung Chen
  • Chunghuang Hubert Chan
  • Cheng-Ta Yang
  • Chih-Cheng Chen
  • Cih-En Huang
  • Chang-Hsien Lu
  • Kuan-Der Lee
Original Paper

DOI: 10.1007/s00432-010-0865-0

Cite this article as:
Chen, MC., Chen, PT., Chan, C.H. et al. J Cancer Res Clin Oncol (2011) 137: 115. doi:10.1007/s00432-010-0865-0

Abstract

Background

Second primary cancer is prevalent in patients with head and neck cancer (HNC), for which esophagus and lung are the most usual sites, associated with an extremely poor prognosis. However, information regarding the actual risk of second primary esophageal or lung cancer in South-east Asia, the betel-quid chewing area, has been restricted to data from single-institutions. We have therefore conducted a population-based study to evaluate the incidence, risk, and developmental time of second esophageal or lung cancer in HNC patients.

Methods

Standardized incidence ratios (SIRs) and cumulative incidences were calculated for second primary esophageal or lung cancer using a database from the Taiwan Cancer Registry that included 63,720 cases having an initial diagnosis of HNC.

Results

The risk of second esophageal cancer was increased in patients with oral/pharyngeal (SIR = 8.71, 95% CI 7.55–10.01) and laryngeal (SIR = 4.65, 95% CI 3.37–6.27) cancers, whereas second lung risk was increased in patients with laryngeal (SIR = 2.05, 95% CI 1.69–2.45) and oral/pharyngeal (SIR = 1.56, 95% CI 1.34–1.80) cancers. The risk excess was prominent for patients with a follow-up interval <5 years and a first primary cancer diagnosed at age <50. Nevertheless, patients with nasopharyngeal carcinoma were not associated with an excess risk in second esophageal or lung cancer.

Conclusions

The present dataset provides definite evidence that there is a substantial excess risk of second primary esophageal or lung cancer for the index tumors of oral cavity, pharynx and larynx. The absence of risk excess found in nasopharyngeal carcinoma is also compatible with the existing knowledge that it might have an entirely distinctive etiology.

Keywords

Head and neck cancerSecond cancerBetel quid chewing

Abbreviations

HNC

Head and neck cancer

SIR

Standardized incidence ratio

CI

Confidence interval

Copyright information

© Springer-Verlag 2010

Authors and Affiliations

  • Min-Chi Chen
    • 1
  • Ping-Tsung Chen
    • 2
    • 3
  • Chunghuang Hubert Chan
    • 2
    • 4
  • Cheng-Ta Yang
    • 5
  • Chih-Cheng Chen
    • 2
    • 4
  • Cih-En Huang
    • 2
  • Chang-Hsien Lu
    • 2
    • 4
  • Kuan-Der Lee
    • 2
    • 3
    • 4
  1. 1.Department of Public Health and Biostatistics Consulting Center, School of MedicineChang Gung UniversityTao-YuanTaiwan, ROC
  2. 2.Department of Hematology and OncologyChang Gung Memorial HospitalChiayiTaiwan, ROC
  3. 3.Department of Medicine and Graduate Institute of Clinical Medical SciencesChang Gung UniversityTao-YuanTaiwan, ROC
  4. 4.Department of NursingChang Gung Institute of TechnologyChiayiTaiwan, ROC
  5. 5.Department of Thoracic MedicineChang Gung Memorial HospitalLinkouTaiwan, ROC