Incidence of second primary cancers in North Portugal—a population-based study
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Longitudinal studies are needed to characterise the burden of second primary malignancies among cancer survivors. Therefore, we quantified the incidence rate and cumulative incidence of second primary cancers (SPC) and standardised incidence ratios (SIR) in a population-based cohort of subjects diagnosed with a first primary cancer (FPC).
We evaluated a cohort of cancer patients from the Portuguese North Region Cancer Registry (RORENO), with the first diagnosis in 2000–2003 (n = 39451), to estimate the incidence rate and cumulative incidence of SPC and standardised incidence ratios (SIR), for different periods of follow-up, up to 5 years; SPC were defined according to the International Association of Cancer Registries and the International Agency for Research on Cancer guidelines.
The incidence rate of SPC was more than 5-fold higher in the first 2 months of follow-up than in the period between 2 months and 5 years (metachronous SPC), across which the incidence rates were relatively stable. Cancer survivors had an overall higher incidence rate of cancer than the general population (SIR = 1.31 (95 % confidence interval (CI), 1.25–1.38)), although that difference faded when only metachronous SPC were considered (SIR = 1.02 (95 % CI, 0.96–1.08)). Cancer incidence rates were higher among female lung FPC survivors and lower in prostate FPC cancer survivors than in the general population. The 5-year cumulative risk of developing a metachronous SPC was 3.0 % and reached nearly 5.0 % among patients with FPC associated with lower risk of death.
Cancer survivors had higher incident rates of cancer that the general population, especially due to diagnoses in the first months following the FPC. Nevertheless, after this period SPC remain frequent events among cancer survivors.
Implications for cancer survivors
SPC constitute an important dimension of the burden of cancer survivorship, and this needs to be taken into account when defining strategies for surveillance, prevention and counselling.
KeywordsNeoplasms Second primary Population-based cancer registry Incidence Mortality
Luís Pacheco-Figueiredo received a grant from the Fundação para a Ciência e a Tecnologia (SFRH/SINTD/60124/2009).
Conflict of interest
The authors declare that they have no conflicts of interest.
- 1.Araujo F, et al. Trends in cardiovascular diseases and cancer mortality in 45 countries from five continents (1980–2010). Eur J Prev Cardiol. 2013.Google Scholar
- 3.Ferlay J et al. GLOBOCAN 2012 v1.0, cancer incidence and mortality worldwide. Lyon: International Agency for Research on Cancer; 2013.Google Scholar
- 4.Pacheco-Figueiredo L, Lunet N. Health status, use of healthcare, and socio-economic implications of cancer survivorship in Portugal: results from the Fourth National Health Survey. J Cancer Surviv. 2014.Google Scholar
- 5.Curtis R, et al. New malignancies among cancer survivors: SEER cancer registries, 1973–2000. National Cancer Institute; NIH Publ., 2006. No. 05-5302.Google Scholar
- 9.International rules for multiple primary cancers (ICD-0 third edition). Eur J Cancer Prev, 2005; 14(4):307–8.Google Scholar
- 10.Howe HL. A review of the definition for multiple primary cancers in the United States. Springfield: North American Association of Central Cancer Registries; 2003.Google Scholar
- 11.RORENO. Registo Oncologico Regional do Norte. IPO - Porto. 2006.Google Scholar
- 21.Morrison A. Screening in chronic disease. New York: Oxford University Press; 1985.Google Scholar
- 22.Cancer trends progress report–2011/2012 update. National Cancer Institute, NIH Publ., 2012.Google Scholar