The effect of multiple primary rules on cancer incidence rates and trends
- 413 Downloads
An examination of multiple primary cancers can provide insight into the etiologic role of genes, the environment, and prior cancer treatment on a cancer patient’s risk of developing a subsequent cancer. Different rules for registering multiple primary cancers (MP) are used by cancer registries throughout the world making data comparisons difficult.
We evaluated the effect of SEER and IARC/IACR rules on cancer incidence rates and trends using data from the SEER Program. We estimated age-standardized incidence rate (ASIR) and trends (1975–2011) for the top 26 cancer categories using joinpoint regression analysis.
ASIRs were higher using SEER compared to IARC/IACR rules for all cancers combined (3 %) and, in rank order, melanoma (9 %), female breast (7 %), urinary bladder (6 %), colon (4 %), kidney and renal pelvis (4 %), oral cavity and pharynx (3 %), lung and bronchus (2 %), and non-Hodgkin lymphoma (2 %). ASIR differences were largest for patients aged 65+ years. Trends were similar using both MP rules with the exception of cancers of the urinary bladder, and kidney and renal pelvis.
The choice of multiple primary coding rules effects incidence rates and trends. Compared to SEER MP coding rules, IARC/IACR rules are less complex, have not changed over time, and report fewer multiple primary cancers, particularly cancers that occur in paired organs, at the same anatomic site and with the same or related histologic type. Cancer registries collecting incidence data using SEER rules may want to consider including incidence rates and trends using IARC/IACR rules to facilitate international data comparisons.
KeywordsIncidence rates Trends Multiple primary cancers Population-based cancer registry SEER IARC IACR
International Association of Cancer Registries
International Agency for Research on Cancer
Surveillance, Epidemiology, and End Results
We would like to thank Ms. Jessica King for help with the joinpoint regression analyses of the SEER 9 data. There are no financial disclosures from any of the authors.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
- 1.Stewart BW, Wild CP (eds) (2014) World cancer Report 2014. Forman D, Ferlay J. The global and regional burden of cancer. International Agency for Research on Cancer, Lyon, France 2014. http://www.iarc.fr/en/publications/pdfs-online/wcr/. Accessed 2 June 2015
- 4.USCS: U.S. Cancer Statistics Working Group (2015) United States Cancer Statistics: 1999–2011 Incidence and Mortality Web-based Report. Atlanta: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention and National Cancer Institute; 2014. www.cdc.gov/uscs. Accessed 2 June 2015
- 5.Howlader N, Noone AM, Krapcho M et al (eds) (2015) SEER Cancer Statistics Review, 1975–2011, National Cancer Institute. Bethesda, MD. http://seer.cancer.gov/csr/1975_2011/. Accessed 2 June 2015
- 6.Copeland G, Lake A, Firth R et al (eds) (2014) Cancer in North America: 2007–2011. Volume One: Combined Cancer Incidence for the United States, Canada and North America. Springfield, IL: North American Association of Central Cancer Registries, Inc. May 2014. http://www.naaccr.org/DataandPublications/CINAPubs.aspx. Accessed 2 June 2015
- 9.Coleman MP, Forman D, Bryant H et al (2011) Cancer survival in Australia, Canada, Denmark, Norway, Sweden, and the UK, 1995–2007 (the International Cancer Benchmarking Partnership): an analysis of population-based cancer registry data. Lancet 377(9760):127–138PubMedCentralCrossRefPubMedGoogle Scholar
- 10.Ferlay J, Bray F, Steliarova-Foucher E et al (eds) (2014) Cancer incidence in five continents, CI5plus: IARC CancerBase No. 9 [Internet]. Lyon, France: International Agency for Research on Cancer, 2014. http://ci5.iarc.fr. Accessed 2 June 2015
- 13.Multiple Primary and Histology Coding Rules. http://seer.cancer.gov/tools/mphrules/. Accessed 9 Apr 2015
- 15.A review of the definition for multiple primary cancers in the United States. http://prdupl02.ynet.co.il/forumfiles_2/19207389.pdf. Accessed 16 Apr 2015
- 16.Ferlay J, Burkhard C, Whelan S, Parkin DM (2005) Check and conversion programs for cancer registries (IACR/IACR Tools for Cancer Registries). IACR Technical Report No. 42 LyonGoogle Scholar
- 19.Fraumeni JF, Curtis RE, Edwards BK, Tucker MA (2006) Chapter 1: Introduction. In: Curtis RE, Freedman DM, Ron E, Ries LAG, Hacker DG, Edwards BK, Tucker MA, Fraumeni JF Jr (eds). New Malignancies among Cancer Survivors: SEER Cancer Registries, 1973–2000. National Cancer Institute, NIH Publ. No. 05-5302, Bethesda, MDGoogle Scholar
- 23.Thornton ML (ed) Standards for Cancer Registries Volume II: Data Standards and Data Dictionary, Record Layout Version 14, 18th ed. Springfield, Ill.: North American Association of Central Cancer Registries, September 2013, revised November 2013. http://www.naaccr.org/StandardsandRegistryOperations/VolumeII.aspx. Accessed 2 June 2015
- 24.SEER Site Recode ICD-O-3 (1/27/2003) Definition. http://seer.cancer.gov/siterecode/icdo3_d01272003. Accessed 2 Apr 2015
- 26.Age-Adjustment Using the 2000 Projected U.S. Population. [Interne] National Center for Health Statistics, Centers for Disease Control and Prevention, 2001. http://www.cdc.gov/nchs/data/statnt/statnt20.pdf. Accessed 15 May 2014
- 27.SEER*stat software. http://seer.cancer.gov/seerstat/. Accessed 9 Apr 2015
- 29.Joinpoint trend analysis software, version 4.1.0. http://surveillance.cancer.gov/joinpoint/. Accessed 9 Apr 2015
- 40.Vincent GK, Velkoff VA (2010) The next four decades: the older population in the United States: 2010 to 2050. Curr Popu Rep P25-1138, US Census Bureau, Washington, DC. http://www.census.gov/prod/2010pubs/p25-1138.pdf. Accessed 2 June 2015
- 43.Ping Ren. Lifetime Mobility in the United States: 2010, American Community Survey Briefs. US Census Bureau; 2011. http://www.census.gov/prod/2011pubs/acsbr10-07.pdf. Accessed 18 June 2014