Clinical and sociodemographic risk factors associated with the development of second primary cancers among postmenopausal breast cancer survivors.
Clinical and sociodemographic risk factors associated with the development of second primary cancers among postmenopausal breast cancer survivors.
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DOI：
10.1007/s12282-022-01411-8
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发表时间：
2023-03
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影响因子：
--
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中科院分区：
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乳腺癌（BC）诊断和治疗的进步增加了长期生存者的数量。因此，原发性BC幸存者发生第二原发性癌症（SPC）的风险更大。BC幸存者中SPC的风险因素包括社会人口学特征、癌症治疗、合并症和合并用药尚未得到全面研究。本研究的目的是评估与BC幸存者SPC风险相关的发病率和临床病理因素。我们分析了2000年1月至2015年12月期间从Medicare相关监测流行病学和最终结果（SEER-Medicare）数据库诊断的171，311名早期原发性BC女性。SPC定义为在研究期间和主要BC诊断后至少6个月内发生的任何恶性肿瘤诊断。单变量分析比较了发生SPC和未发生SPC的患者的基线特征。我们评估了在存在死亡的情况下发生SPC的原因特异性危害作为竞争风险。在研究队列中，21，510名（13%）BC幸存者发生了SPC，BC是最常见的SPC类型（28%）。至SPC的中位时间为44个月。白色、年龄较大、合并症较少的女性更有可能发生SPC。而他汀类药物[风险比（HR）1.066（1.023-1.110）]和降压药[HR 1.569（1.512-1.627）]增加了形成SPC的危险，芳香化酶抑制剂治疗[HR 0.620（0.573-0.671）]和双膦酸盐[HR 0.905（0.857-0.956）]与发生任何SPC（包括非乳腺SPC）的风险降低相关。我们的研究表明，特定的临床因素，包括癌症治疗的类型，药物和合并症与老年BC幸存者发生SPC的风险增加有关。这些结果可以提高患者和临床医生的认识，在BC幸存者中进行癌症筛查，并制定适应风险的管理策略。
Advancement in breast cancer (BC) diagnosis and treatment have increased the number of long-term survivors. Consequently, primary BC survivors are at a greater risk of developing second primary cancers (SPCs). The risk factors for SPCs among BC survivors including sociodemographic characteristics, cancer treatment, comorbidities, and concurrent medications have not been comprehensively examined. The purpose of this study is to assess the incidence and clinicopathologic factors associated with risk of SPCs in BC survivors. We analyzed 171, 311 women with early-stage primary BC diagnosed between January 2000 and December 2015 from the Medicare-linked Surveillance Epidemiology and End Results (SEER-Medicare) database. SPC was defined as any diagnosis of malignancy occurring within the study period and at least 6 months after primary BC diagnosis. Univariate analyses compared baseline characteristics between those who developed a SPC and those who did not. We evaluated the cause-specific hazard of developing a SPC in the presence of death as a competing risk. Of the study cohort, 21,510 (13%) of BC survivors developed a SPC and BC was the most common SPC type (28%). The median time to SPC was 44 months. Women who were white, older, and with fewer comorbidities were more likely to develop a SPC. While statins [hazard ratio (HR) 1.066 (1.023–1.110)] and anti-hypertensives [HR 1.569 (1.512–1.627)] increased the hazard of developing a SPC, aromatase inhibitor therapy [HR 0.620 (0.573–0.671)] and bisphosphonates [HR 0.905 (0.857–0.956)] were associated with a decreased hazard of developing any SPC, including non-breast SPCs. Our study shows that specific clinical factors including type of cancer treatment, medications, and comorbidities are associated with increased risk of developing SPCs among older BC survivors. These results can increase patient and clinician awareness, target cancer screening among BC survivors, as well as developing risk-adapted management strategies.
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DOI：
10.1093/jnci/djk054
发表时间：
2007-02-21
期刊：
JOURNAL OF THE NATIONAL CANCER INSTITUTE
影响因子：
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作者：
Daubine, Florence;Le Gall, Celine;Clezardin, Philippe
通讯作者：
Clezardin, Philippe
DOI：
10.1158/1055-9965.epi-17-0346
发表时间：
2017-11
期刊：
Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology
影响因子：
--
作者：
Chen L;Chubak J;Boudreau DM;Barlow WE;Weiss NS;Li CI
通讯作者：
Li CI
DOI：
10.1158/1055-9965.epi-17-0556
发表时间：
2018-03
期刊：
Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology
影响因子：
--
作者：
Korde LA;Doody DR;Hsu L;Porter PL;Malone KE
通讯作者：
Malone KE
影响因子：
51.1
作者：
de Gonzalez, Amy Berrington;Curtis, Rochelle E.;Kry, Stephen F.;Gilbert, Ethel;Lamart, Stephanie;Berg, Christine D.;Stovall, Marilyn;Ron, Elaine
通讯作者：
Ron, Elaine
影响因子：
5.5
作者：
Biello F;Platini F;D'Avanzo F;Cattrini C;Mennitto A;Genestroni S;Martini V;Marzullo P;Aimaretti G;Gennari A
通讯作者：
Gennari A