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Second primary cancers in patients with nasopharyngeal carcinoma: a pooled analysis of 13 cancer registries

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Abstract

Objective

To study the risk of second primary cancers in nasopharyngeal carcinoma (NPC) patients and the risk of NPC as second primary cancer.

Methods

We used data from the cancer registries from Singapore and from 12 low-incidence areas, including a total of 8,947 first occurring NPC cases, and 167 second occurring cases. We calculated standardized incidence ratios (SIRs) by comparing the second cancer incidence in NPC patients to the first primary cancer incidence in non-cancer population. We also calculated SIRs of second NPC after other primaries.

Results

In Singapore, the risk of cancers of the lung (SIR = 0.42), stomach (SIR = 0.41), and colon (SIR = 0.23) was significantly decreased after NPC, whereas that of cancer of the tongue (SIR = 11.1) was significantly increased. In Australia, Canada, and Europe, the risk of non-Hodgkin’s lymphoma (NHL) (SIR = 3.06), tongue cancer (SIR = 5.29), brain cancer (SIR = 3.89), myeloid leukemia (SIR = 3.85), and non-melanoma skin cancer (NMSC) (SIR = 3.47) was significantly increased after NPC. Incidences of second occurring NPCs following various primary cancers were not significantly altered compared to the incidence of first occurring NPCs.

Conclusions

Immune suppression (NHL, NMSC), shared genetic factors (lung cancer, NHL, myeloid leukemia), and shared environmental risk factors (tongue and brain cancers) might explain the associations. Except for NHL, there was no evidence of association with other Epstein-Barr virus-related cancers.

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Acknowledgements

Research grant & financial support: Supported by a grant R03 CA101442-02 from the National Cancer Institute (P. Brennan). G. Scélo worked on this study during the tenure of a Special Training Award from the International Agency for Research on Cancer.

Author information

Authors and Affiliations

  1. International Agency for Research on Cancer, 150 cours Albert Thomas, Lyon, 69008, France

    Ghislaine Scélo, Paolo Boffetta, Marilys Corbex & Paul Brennan

  2. Center for Molecular Epidemiology, National University of Singapore, Singapore, Singapore

    Kee-Seng Chia

  3. Singapore Cancer Registry, Singapore, Singapore

    Kee-Seng Chia

  4. Division of Molecular Genetic Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany

    Kari Hemminki

  5. Center of Family Medicine, Karolinska Institutet, Huddinge, Sweden

    Kari Hemminki

  6. Institute of Cancer Epidemiology, Danish Cancer Society, Copenhagen, Denmark

    Soren Friis

  7. Finnish Cancer Registry, Institute for Statistical and Epidemiology Cancer Research, Helsinki, Finland

    Eero Pukkala

  8. The Cancer Registry of Norway, Oslo, Norway

    Elisabete Weiderpass

  9. Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden

    Elisabete Weiderpass

  10. British Columbia Cancer Agency, Vancouver, British Columbia, Canada

    Mary L. McBride

  11. New South Wales Cancer Registry, Eveleigh, New South Wales, Australia

    Elizabeth Tracey

  12. Scottish Cancer Registry, Information Services, NHS National Services Scotland, Edinburgh, Scotland, UK

    David H. Brewster

  13. Cancer Registry of Slovenia, Institute of Oncology, Ljubljana, Slovenia

    Vera Pompe-Kirn

  14. Epidemiology and Cancer Registry, CancerCare Manitoba, Winnipeg, Canada

    Erich V. Kliewer

  15. Community Health Sciences, University of Manitoba, Winnipeg, Canada

    Erich V. Kliewer

  16. School of Public Health, University of Sydney, Sydney, New South Wales, Australia

    Erich V. Kliewer

  17. Saskatchewan Cancer Agency, Regina, Saskatchewan, Canada

    Jon M. Tonita

  18. Cancer Registry of Zaragoza, Health Department of Aragon Government, Zaragoza, Spain

    Carmen Martos

  19. Icelandic Cancer Registry, Icelandic Cancer Society, Reykjavik, Iceland

    Jon G. Jonasson

  20. Faculty of Medicine, University of Iceland, Reykjavik, Iceland

    Jon G. Jonasson

Authors
  1. Ghislaine Scélo
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  2. Paolo Boffetta
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  3. Marilys Corbex
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  4. Kee-Seng Chia
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  5. Kari Hemminki
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  7. Eero Pukkala
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  8. Elisabete Weiderpass
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  9. Mary L. McBride
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  10. Elizabeth Tracey
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  11. David H. Brewster
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  12. Vera Pompe-Kirn
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  13. Erich V. Kliewer
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  14. Jon M. Tonita
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  15. Carmen Martos
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  16. Jon G. Jonasson
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  17. Paul Brennan
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Corresponding author

Correspondence to Paolo Boffetta.

Additional information

Research grant and financial support: Supported by a grant R03 CA101442-02 from the National Cancer Institute (P. Brennan). G. Scélo worked on this study during the tenure of a Special Training Award from the International Agency for Research on Cancer.

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Scélo, G., Boffetta, P., Corbex, M. et al. Second primary cancers in patients with nasopharyngeal carcinoma: a pooled analysis of 13 cancer registries. Cancer Causes Control 18, 269–278 (2007). https://doi.org/10.1007/s10552-006-0101-z

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  • DOI: https://doi.org/10.1007/s10552-006-0101-z

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