Incidence of metachronous second primary cancers in Osaka, Japan: Update of analyses using population-based cancer registry data
Incidence of metachronous second primary cancers in Osaka, Japan: Update of analyses using population-based cancer registry data
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DOI：
10.1111/j.1349-7006.2012.02254.x
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发表时间：
2012-06-01
期刊：
影响因子：
5.7
通讯作者：
Tsukuma, Hideaki
中科院分区：
文献类型：
--
作者：
Tabuchi, Takahiro;Ito, Yuri;Tsukuma, Hideaki
癌症幸存者患第二原发癌症的风险过高，但日本患者的确切风险水平尚不清楚。为了调查幸存者患第二原发癌症的风险，我们利用大阪癌症登记处的数据进行了一项回顾性队列研究。研究对象包括所有报告的年龄为 079 岁的患者，他们于 1985 年至 2004 年之间在大阪首次被诊断出患有癌症，并且存活了至少 3 个月，随访至 2005 年 12 月。异时性第二原发性癌症的定义是在首次癌症诊断后 3 个月至 10 年内诊断出的任何侵袭性第二原发性癌症。主要结果指标是每10万人年的发病率、第二原发癌的累积风险和标准化发病率（SIR）。中位随访 2.5 年后，355 966 名幸存者中有 13 385 名（3.8%）发生异时性第二原发癌。每 10 万人年异时性第二原发癌的性别特异性发病率随着年龄的增长而增加，男性高于女性（049 岁年龄组除外），但这些发病率在研究期间没有差异。对于 6069 岁首次患癌症的人，10 年累积风险估计为 13.0%（男性 16.2%，女性 8.6%）。 039 岁和 4049 岁首次诊断出癌症的男女的 SIR 分别为 2.13 和 1.52，而就部位关系而言，口腔/咽癌、食道癌和喉癌的 SIR 远高于 1。我们发现，与一般人群相比，日本大阪的癌症幸存者患第二原发癌症的风险更高。我们的研究结果表明，第二原发癌症应被视为常见的重大医学问题。需要进一步的研究来加深我们的理解，从而能够制定针对多种原发性癌症的有效措施。 （癌症科学 2012 年；103：11111120）
Cancer survivors are at excess risk of developing second primary cancers, but the precise level of risk in Japanese patients is not known. To investigate the risk of survivors developing second primary cancers, we conducted a retrospective cohort study using data from the Osaka Cancer Registry. The study subjects comprised all reported patients aged 079 years who were first diagnosed with cancer between 1985 and 2004 in Osaka and who survived for at least 3 months, followed-up through to December 2005. A metachronous second primary cancer was defined as any invasive second cancer that was diagnosed between 3 months and 10 years after the first cancer diagnosis. The main outcome measures were incidence rates per 100 000 person-years, cumulative risk and standardized incidence ratios (SIR) of second primary cancer. Metachronous second primary cancers developed in 13 385 of 355 966 survivors (3.8%) after a median follow-up of 2.5 years. Sex-specific incidence rates of metachronous second primary cancer per 100 000 person-years increased with age, and were higher among men than women (except for the 049 years age group), but these rates did not differ over the study period. The 10-year cumulative risk was estimated as 13.0% for those who first developed cancer at 6069 years of age (16.2% for men, 8.6% for women). The SIR among those with first cancer diagnosed at 039 and 4049 years of age were 2.13 and 1.52, respectively, in both sexes, whereas the SIR among cancers of the mouth/pharynx, esophagus and larynx were much higher than one as for site relationships. We showed that cancer survivors in Osaka, Japan, were at higher risk of second primary cancers compared with the general population. Our findings indicate that second primary cancers should be considered as a commonly encountered major medical problem. Further investigations are required to advance our understanding to enable the development of effective measures against multiple primary cancers. (Cancer Sci 2012; 103: 11111120)