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Population-based risk assessment of second primary cancers following a first head and neck cancer: patterns of association and difficulties of its analysis

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Abstract

Purpose

The diagnosis of a second primary cancer (SPC) is a major concern in the follow-up of survivors of a primary head and neck cancer (HNC), but the anatomic subsites in the head and neck area are close, making it difficult to distinguish a SPC of a recurrence and therefore register it correctly.

Methods

We performed a retrospective cohort study using data from two population-based cancer registries in Catalonia, Spain: the Tarragona Cancer Registry and the Girona Cancer Registry. All patients diagnosed with HNC during the period 1994–2013 were registered and followed-up to collect cases of SPC. We analysed the standardized incidence ratio (SIR) and the excess absolute risk (EAR) to determine the risk of second malignancies following a prior HNC.

Results

923 SPC were found in a cohort of 5646 patients diagnosed of a first head and neck cancer. Men had an increased risk of a SPC with a SIR of 2.22 and an EAR of 216.76. Women also had an increased risk with a SIR of 2.02 and an EAR of 95.70. We show the risk for different tumour sites and discuss the difficulties of the analysis.

Conclusion

The risks of a SPC following a prior HNC in Tarragona and Girona are similar to those previously found in other similar cohorts. It would appear to be advisable to make a revision of the international rules of classification of multiple tumours, grouping the sites of head and neck area with new aetiological criteria to better determine and interpret the risks of SPC obtained in these studies.

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Acknowledgements

We thank Katie Linder for reviewing the English grammar of the manuscript.

Funding

This research did not receive any specific grants from public, commercial, or not-for-profit funding agencies.

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Author notes

  1. J. Rubió-Casadevall and J. Galceran contributed equally to the study and manuscript.

Authors and Affiliations

  1. Medical Oncology Department, Institut Català d’Oncologia de Girona, Avda França s/n, 17005, Girona, Spain

    J. Rubió-Casadevall & A. Izquierdo

  2. Descriptive Epidemiology, Genetics and Cancer Prevention Group, Biomedical Research Institute (IDIBGI), Girona, Spain

    J. Rubió-Casadevall, M. Puigdemont, J. Marruecos, A. Izquierdo & R. Marcos-Gragera

  3. Tarragona Cancer Registry, Hospital Universitari de Sant Joan, IISPV, Universitat Rovira i Virgili, Reus, Spain

    J. Galceran, A. Ameijide, L. Llauradó, M. Carulla & J. L. Borràs

  4. Epidemiology Unit and Girona Cancer Registry, Oncology Coordination Plan, Department of Health Government of Catalonia, Catalan Institute of Oncology, Girona, Spain

    M. Puigdemont, A. Izquierdo & R. Marcos-Gragera

  5. Radiotherapy Oncology Department, Institut Català d’Oncologia de Girona, Girona, Catalonia, Spain

    J. Marruecos

  6. Institute of Oncology of Southern Catalonia, Hospital Universitari de Sant Joan, IISPV, Reus, Spain

    J. L. Borràs & J. Gumà

  7. Institut d’Investigació Sanitària Pere Virgili (IISPV), Reus, Catalonia, Spain

    J. Gumà

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  1. J. Rubió-Casadevall
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Contributions

JRC, JGa, JM, AI, JB, MC, RMG and JGu contributed to study design and to the analysis and interpretation of the study results. JRC and JGa wrote the manuscript. MP was responsible for the databases in Girona Cancer Registry (GCR). LL were responsible for the databases in Tarragona Cancer Registry (TCR). AA performed the statistical analysis. JGa and MC are the coordinators of the TCR. RMG and AI are the coordinators of the GCR. All authors corrected and approved the final manuscript.

Corresponding author

Correspondence to J. Rubió-Casadevall.

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Conflict of interest

The authors declare that they have no competing interests.

Ethical approval

This study uses anonymous data and complies with all the laws and rules of the National Health System that regulates the activity of population-based cancer registries.

Informed consent

For this type of study formal consent is not required.

Availability of data and material

This study was carried out using anonymized data from the Girona Cancer Registry (GCR) and Tarragona Cancer Registry (TCR) which comply with the legal regulations for data protection and management of clinical data in force in Spain. Both registries belong to and comply with the regulations of the International Association of Cancer Registries (IACR) and the International Agency for Research in Cancer (IARC). No intervention has been performed on human or animal subjects. All procedures have been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki.

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Rubió-Casadevall, J., Galceran, J., Ameijide, A. et al. Population-based risk assessment of second primary cancers following a first head and neck cancer: patterns of association and difficulties of its analysis. Clin Transl Oncol 23, 788–798 (2021). https://doi.org/10.1007/s12094-020-02470-z

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  • DOI: https://doi.org/10.1007/s12094-020-02470-z

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