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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

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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.

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Abbreviations

HNC:

Head and neck cancer

SIR:

Standardized incidence ratio

CI:

Confidence interval

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Acknowledgments

We thank all the staff in the Taiwan Cancer Registry and Bureau of Health Promotion, National Department of Health, Taiwan, R.O.C. This work was supported by National Science Council grants NSC98-2314-B-182-029-MY2.

Competing interests

The authors declare that they have no competing interests.

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Authors and Affiliations

  1. Department of Public Health and Biostatistics Consulting Center, School of Medicine, Chang Gung University, Tao-Yuan, Taiwan, ROC

    Min-Chi Chen

  2. Department of Hematology and Oncology, Chang Gung Memorial Hospital, 6 West Sec., Chia-Pu Road, Pu-Tz city, Chiayi, 613, Taiwan, ROC

    Ping-Tsung Chen, Chunghuang Hubert Chan, Chih-Cheng Chen, Cih-En Huang, Chang-Hsien Lu & Kuan-Der Lee

  3. Department of Medicine and Graduate Institute of Clinical Medical Sciences, Chang Gung University, Tao-Yuan, Taiwan, ROC

    Ping-Tsung Chen & Kuan-Der Lee

  4. Department of Nursing, Chang Gung Institute of Technology, Chiayi, Taiwan, ROC

    Chunghuang Hubert Chan, Chih-Cheng Chen, Chang-Hsien Lu & Kuan-Der Lee

  5. Department of Thoracic Medicine, Chang Gung Memorial Hospital, Linkou, Taiwan, ROC

    Cheng-Ta Yang

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  1. Min-Chi Chen
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Correspondence to Kuan-Der Lee.

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Chen, MC., Chen, PT., Chan, C.H. et al. 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. J Cancer Res Clin Oncol 137, 115–123 (2011). https://doi.org/10.1007/s00432-010-0865-0

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  • DOI: https://doi.org/10.1007/s00432-010-0865-0

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