Skip to main content

Advertisement

SpringerLink
Log in

Risk of second primary malignancies following nasopharyngeal carcinoma in Hong Kong

  • Original paper
  • Published:
Cancer Causes & Control Aims and scope Submit manuscript

Abstract

Nasopharyngeal carcinoma (NPC) is rare in most of the world but common among southeast Asians. Since NPC is usually diagnosed at relatively young ages and most patients now survive, the issue of second primary tumors (SPTs) has become important. Previous studies of SPTs among NPC survivors have given conflicting results. Data on patients with NPC diagnosed between 1996 and 2002 were abstracted from the medical records of two Hong Kong oncology centers. SPT incidence in these patients was compared to that of Hong Kong’s general population using standardized incidence ratios (SIR). Eight-four patients were observed to have at least 1 SPT and 92 total additional cancers (SIR = 1.93, 95% CI = 1.55–2.37). The excess risk was greater for women and patients under 40 at diagnosis. Significant excesses were found for tongue, lung, nasal and middle ear, and brain cancers. The pattern of sites at which the greatest excess risk occurred is consistent with the hypothesis that much of the excess is due to treatment effects. The greater excess risk among patients diagnosed before 40 points to possible genetic influences. More research is needed to determine the reasons for greater excess risk among women.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Neugut AI, Meadows AT, Robinson E (1999) Introduction. In: Neugut AI, Meadows AT, Robinson E (eds) Multiple primary cancers. Lippincott Williams & Wilkins, Philadelphia, pp 6–8

    Google Scholar 

  2. Yu MC, Yuan JM (2002) Epidemiology of nasopharyngeal carcinoma. Semin Cancer Biol 12(6):421–429

    Article  PubMed  Google Scholar 

  3. Hong Kong Cancer Stat 2002 Version I. Published by Hong Kong Cancer Registry, Hospital Authority May 2005

  4. Lee AWM, Foo W, Mang O, Chappell R, Lau WH, Ko WM (2003) Changing epidemiology of nasopharyngeal carcinoma in Hong Kong over a 20 year period (1980–1999): an encouraging reduction in both incidence and mortality. Int J Cancer 103:680–685

    Article  CAS  PubMed  Google Scholar 

  5. Chan ACT, Teo PML, Johnson PJ (2002) Nasopharyngeal carcinoma. Ann Oncol 13:1007–1015

    Article  CAS  PubMed  Google Scholar 

  6. Lu CC, Chen JC, Tsai ST, Jin YT, Tsai JC, Chan SH, Su IJ (2005) Nasopharyngeal carcinoma-susceptibility locus is localized to a 132 kb segment containing HLA-A using high-resolution microsatellite mapping. Int J Cancer 115(5):742–746

    Article  CAS  PubMed  Google Scholar 

  7. Sham JST, Wei WI, Tai PTH, Choy D (1990) Multiple malignant neoplasms in patients with nasopharyngeal carcinoma. Oncology 47:471–474

    Article  CAS  PubMed  Google Scholar 

  8. Teo PML, Chan ATC, Leung SF, Chau RM, Yu PK, King WW, Johnson PJ (1999) Increased incidence of tongue cancer after primary radiotherapy for nasopharyngeal carcinoma—the possibility of radiation carcinogenesis. Eur J Cancer 35(2):219–225

    Article  CAS  PubMed  Google Scholar 

  9. Wang CC, Chen ML, Hsu KH, Lee SP, Chen TC, Chang YS, Tsang NM, Hong JH (2000) Second malignant tumors in patients with nasopharyngeal carcinoma and their association with Epstein-Barr virus. Int J Cancer 87:228–231

    Article  CAS  PubMed  Google Scholar 

  10. Scelo G, Boffetta P, Corbex M, Chia KS, Hemminki K, Friis S, Pukkala E, Weiderpass E, McBride ML, Tracey E, Brewster DH, Pompe-Kirn V, Kliewer EV, Tonita JM, Martos C, Jonasson JG, Brennan P (2007) Second primary cancers in patients with nasopharyngeal carcinoma: a pooled analysis of 13 cancer registries. Cancer Causes Control 18:269–278

    Article  PubMed  Google Scholar 

  11. Chen MC, Feng IJ, Lu CH, Chen CC, Lin JT, Huang SH, Lee KD (2008) The incidence and risk of second primary cancers in patients with nasopharyngeal carcinoma: a population-based study in Taiwan over a 25-year period (1979–2003). Ann Oncol 19:1180–1186

    Article  PubMed  Google Scholar 

  12. Tse LA, Mang OWK, Yu ITS, Wu F, Au JSK, Law SCK (2009) Cigarette smoking and changing trends of lung cancer incidence by histological subtype among Chinese male populations. Lung Cancer 66(1):22–27

    Article  PubMed  Google Scholar 

  13. Hong Kong Cancer Registry website. Retrieved March 15. 2010 from the world wide web: http://www3.ha.org.hk/cancereg/e_faq.asp

  14. Chiu SS, Lau YL, Chan KH, Wong WH, Peiris JS, Influenza related hospitalizations among children in Hong Kong. 347(26): 2097–2103

  15. Uitenbroek DG (1997) SISA SMR-Exact. Southampton: Uitenbroek DG Retrieved June 10, 2009, from the World Wide Web: http://www.quantitativeskills.com/sisa/statistics/smr.htm

  16. Goggins WB (2008) Re: second primary cancers in patients with nasopharyngeal carcinoma: a pooled analysis of 13 cancer registries. Cancer Causes Control 19(10):1409–1410

    Article  PubMed  Google Scholar 

  17. Yu MC, Ho JHC, Lai SH, Henderson BE (1986) Cantonese-style salted fish as a cause of nasopharyngeal carcinoma: report of a case-control study in Hong Kong. Cancer Res 46:956–961

    CAS  PubMed  Google Scholar 

  18. Hu J, LaVecchia C, Negri E, Chatenoud L, Bosetti C, Jia X, Liu R, Huang G, Bi D, Wang C (1999) Diet and brain cancer in adults: a case-control study in Northeast China. Int J Cancer 81(1):20–23

    Article  CAS  PubMed  Google Scholar 

  19. Blowers L, Preston-Martin S, Mack WJ (1997) Dietary and other lifestyle factors of women with brain gliomas in Los Angeles County (California, USA). Cancer Causes Control 8:5–12

    Article  CAS  PubMed  Google Scholar 

  20. Lee M, Wrensch M, Miike R (1997) Dietary and tobacco risk factors for adult onset glioma in the San Francisco Bay Area (California, USA). Cancer Causes Control 8:13–24

    Article  CAS  PubMed  Google Scholar 

  21. Yuan JM, Wang XL, Xiang YB, Gao YT, Ross RK, Yu MC (2000) Non-dietary risk factors for nasopharyngeal carcinoma in Shanghai, China. Int J Cancer 85:364–369

    Article  CAS  PubMed  Google Scholar 

  22. Yu MC, Garabrant DH, Huang TB, Henderson BE (1990) Occupational and other non-dietary risk factors for nasopharyngeal carcinoma in Guangzhou, China. Int J Cancer 45:1033–1039

    Article  CAS  PubMed  Google Scholar 

  23. Nam JM, McLaughlin JK, Blot WJ (1992) Cigarette smoking, alcohol, and nasopharyngeal carcinoma: a case-control study among U.S. whites. J Natl Cancer Inst 84:619–622

    Article  CAS  PubMed  Google Scholar 

  24. West S, Hildesheim A, Dosemeci M (1993) Non-viral risk factors for nasopharyngeal carcinoma in the Philippines: results from a case-control study. Int J Cancer 55:722–727

    Article  CAS  PubMed  Google Scholar 

  25. Chow WH, McLaughlin JK, Hrubec Z, Nam JM, Blot WJ (1993) Tobacco use and nasopharyngeal carcinoma in a cohort of US veterans. Int J Cancer 55:538–540

    Article  CAS  PubMed  Google Scholar 

  26. Zhu K, Levine RS, Brann EA, Gnepp DR, Baum MK (1995) A population-based case-control study of the relationship between cigarette smoking and nasopharyngeal cancer (United States). Cancer Causes Control 6:507–512

    Article  CAS  PubMed  Google Scholar 

  27. Vaughan TL, Shapiro JA, Burt RD, Swanson GM, Berwick M, Lynch CF, Lyon JL (1996) Nasopharyngeal cancer in a low-risk population: defining risk factors by histological type. Cancer Epidemiol Biomarkers Prev 5:587–593

    CAS  PubMed  Google Scholar 

  28. Cheng YJ, Hildesheim A, Hsu MM, Chen IH, Brinton LA, Levine PH, Chen CJ, Yang CS (1999) Cigarette smoking, alcohol consumption and risk of nasopharyngeal carcinoma in Taiwan. Cancer Causes Control 10:201–207

    Article  CAS  PubMed  Google Scholar 

  29. Tubiana M (2009) Can we reduce the incidence of second primary malignancies occurring after radiotherapy: a critical review. Radiother Oncol 91:4–15

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

This research was supported by Research Grants Council of Hong Kong Competitive Earmarked Research Grant Reference Number CUHK 4531/06 M. We wish to thank the reviewers whose helpful comments have greatly improved the quality of this manuscript.

Conflict of interest statement

All authors declare that they have neither personal/financial conflict of interest nor relationship with other people or organisations that could inappropriately influence their work.

Author information

Authors and Affiliations

  1. Division of Biostatistics, School of Public Health and Primary Care, Chinese University of Hong Kong, Hong Kong, China

    William B. Goggins

  2. Division of Occupational and Environmental Health, School of Public Health and Primary Care, Chinese University of Hong Kong, Hong Kong, China

    Ignatius T. S. Yu, Lap Ah Tse & Kai Sing Yu

  3. Department of Clinical Oncology, Chinese University of Hong Kong, Hong Kong, China

    Sing Fai Leung

  4. Department of Clinical Oncology, Tuen Mun Hospital, Hong Kong, China

    Stewart Y. Tung

Authors
  1. William B. Goggins
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ignatius T. S. Yu
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Lap Ah Tse
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Sing Fai Leung
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Stewart Y. Tung
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Kai Sing Yu
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to William B. Goggins.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Goggins, W.B., Yu, I.T.S., Tse, L.A. et al. Risk of second primary malignancies following nasopharyngeal carcinoma in Hong Kong. Cancer Causes Control 21, 1461–1466 (2010). https://doi.org/10.1007/s10552-010-9574-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10552-010-9574-x

Keywords

Search

Navigation