Incidence of second and higher order smoking-related primary cancers following lung cancer: a population-based cohort study
Incidence of second and higher order smoking-related primary cancers following lung cancer: a population-based cohort study
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DOI：
10.1136/thoraxjnl-2018-212456
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发表时间：
2019-05-01
期刊：
影响因子：
10
通讯作者：
Rintoul, Robert C.
中科院分区：
文献类型：
--
作者：
Barclay, Matthew E.;Lyratzopoulos, Georgios;Rintoul, Robert C.
背景 15 年来，肺癌的 5 年生存率增加了一倍。尽管人们已经认识到第二原发癌症的风险，但缺乏随时间的量化。我们描述了肺癌幸存者中与吸烟相关的二级及以上原发性癌症的发病率，确定了高发病率群体，以及发病率自首次诊断以来随时间的变化情况。 方法 2000 年至 2014 年间在英国诊断出的与吸烟相关的原发性癌症（肺癌、喉癌、头颈癌、食管鳞状细胞癌和膀胱癌）的数据来自英国公共卫生国家癌症登记和分析服务。我们使用泊松回归计算了从肺癌初次诊断起长达 10 年的第二原发癌总体和各个亚组的绝对发病率和标准化发病率比。结果 自首次诊断出肺癌起，与吸烟相关的第二原发癌的发病率升高持续至少 10 年，其中首次诊断时年龄为 50 岁和 79 岁的人风险特别高。最常见的第二种恶性肿瘤是肺癌，尽管食管鳞状细胞癌 (2.4) 和喉癌 (2.8) 的标准化发病率比率最高，并且女性的发病率始终高于男性。在过去的十年中，第二原发性肺癌的发病率增加了一倍。 结论 自首次诊断起至少十年内，肺癌幸存者的后续肺癌、喉癌、头颈癌和食管鳞状细胞癌的发病率有所增加。应考虑将高危人群的常规随访时间从 5 年增加到 10 年，同时监测其他与吸烟相关的癌症。
Background Lung cancer 5-year survival has doubled over 15 years. Although the risk of second primary cancer is recognised, quantification over time is lacking. We describe the incidence of second and higher order smoking-related primary cancers in lung cancer survivors, identifying high-incidence groups and how incidence changes over time from first diagnosis.Methods Data on smoking-related primary cancers (lung, laryngeal, head and neck, oesophageal squamous cell carcinoma and bladder) diagnosed in England between 2000 and 2014 were obtained from Public Health England National Cancer Registration and Analysis Service. We calculated absolute incidence rates and standardised incidence rate ratios, both overall and for various subgroups of second primary cancer for up to 10 years from the initial diagnosis of lung cancer, using Poisson regression.Results Elevated incidence of smoking-related second primary cancer persists for at least 10 years from first lung cancer diagnosis with those aged 50 and 79 at first diagnosis at particularly high risk. The most frequent type of second malignancy was lung cancer although the highest standardised incidence rate ratios were for oesophageal squamous cell carcinoma (2.4) and laryngeal cancers (2.8) and consistently higher in women than in men. Over the last decade, the incidence of second primary lung cancer has doubled.Conclusion Lung cancer survivors have increased the incidence of subsequent lung, laryngeal, head and neck and oesophageal squamous cell carcinoma for at least a decade from the first diagnosis. Consideration should be given to increasing routine follow-up from 5 years to 10 years for those at highest risk, alongside surveillance for other smoking-related cancers.