The Incidence Characteristics of Second Primary Malignancy after Diagnosis of Primary Colon and Rectal Cancer: A Population Based Study
The Incidence Characteristics of Second Primary Malignancy after Diagnosis of Primary Colon and Rectal Cancer: A Population Based Study
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DOI：
10.1371/journal.pone.0143067
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发表时间：
2015-11-16
期刊：
影响因子：
3.7
通讯作者：
Wang, Xishan
中科院分区：
文献类型：
--
作者：
Guan, Xu;Jin, Yinghu;Wang, Xishan
随着美国结直肠癌（CRC）幸存者人数的增加，一个值得关注的问题是这些CRC幸存者发生第二原发恶性肿瘤（SPM）的风险。本研究旨在分析原发性结肠癌（CC）和直肠癌（RC）确诊后SPM的发病特点。我们对CC和RC中SPM的发病趋势进行了比率分析。根据年龄、种族和分期、首次CRC诊断的日历年和首次CRC诊断后的潜伏期对预期发病率进行分层。标准化发病率比（SIRs），衡量估计的风险SPM，分别计算CC和RC。结果SPM的发病率在CC和RC的趋势是从1992年至2012年下降。CC和RC幸存者发生SPM的风险较高（SIRCC = 1.13; SIRRC = 1.05）。在CC患者中，SPM风险最高的是小肠癌（SIR = 4.03）、结肠癌（SIR = 1.87）和直肠癌（SIR = 1.80）。直肠癌（SIR = 2.88）、小肠癌（SIR = 2.16）和甲状腺癌（SIR = 1.46）是直肠癌患者发生SPM的最高风险。根据分层分析，我们还确定了发病率的特点，这有助于发展SPM的风险较高，包括年龄在20和40之间，美洲印第安人/阿拉斯加原住民，本地化阶段，诊断日历年从2002年至2012年和12和59个月之间的潜伏期。确定SPM的发病率特征对于CRC幸存者的持续癌症监测至关重要。
BackgroundWith the expanding population of colorectal cancer (CRC) survivors in the United States, one concerning issue is the risk of developing second primary malignancies (SPMs) for these CRC survivors. The present study attempts to identify the incidence characteristics of SPMs after diagnosis of first primary colon cancer (CC) and rectal cancer (RC).Methods189,890 CC and 83,802 RC cases were identified from Surveillance, Epidemiology and End Results Program (SEER) database. We performed rate analysis on incidence trend of SPMs in both CC and RC. Expected incidence rates were stratified by age, race and stage, calendar year of first CRC diagnosis and latency period since first CRC diagnosis. The standardized incidence ratios (SIRs), measure for estimating risk of SPMs, were calculated for CC and RC respectively.ResultsThe trends of incidence of SPMs in both CC and RC were decreasing from 1992 to 2012. Both CC and RC survivors had higher risk of developing SPMs (SIRCC = 1.13; SIRRC = 1.05). For CC patients, the highest risks of SPM were cancers of small intestine (SIR = 4.03), colon (SIR = 1.87) and rectum (SIR = 1.80). For RC patients, the highest risks of SPMs were cancers of rectum (SIR = 2.88), small intestine (SIR = 2.16) and thyroid (SIR = 1.46). According to stratified analyses, we also identified incidence characteristics which were contributed to higher risk of developing SPMs, including the age between 20 and 40, American Indian/Alaska Native, localized stage, diagnosed at calendar year from 2002 to 2012 and the latency between 12 and 59 months.ConclusionsBoth CC and RC survivors remain at higher risk of developing SPMs. The identification of incidence characteristics of SPMs is extremely essential for continuous cancer surveillance among CRC survivors.