Second cancer following cancer of the female genital system in Connecticut, 1935-82.
Second cancer following cancer of the female genital system in Connecticut, 1935-82.
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康涅狄格州继女性生殖系统癌症之后的第二种癌症，1935-82 年。
DOI：
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发表时间：
1985
期刊：
影响因子：
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通讯作者：
E. B. Harvey
中科院分区：
文献类型：
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作者：
R. Curtis;R. Hoover;R. Kleinerman;E. B. Harvey
在1935年至1982年期间，在康涅狄格州对25，000多名患有生殖器官癌症的妇女进行了第二原发性癌症风险评估。在宫颈癌（35%，n = 656）、子宫体癌（16%，n = 1，060）和卵巢癌（58%，n = 366）之后观察到后续癌症的显著过度。当观察到的和预期的女性生殖道的第二个癌症被排除在外，这些过剩成为40%，30%和59%后，宫颈，子宫体和卵巢，分别。在患有宫颈癌或子宫体癌的妇女中，随着随访时间的增加，发生第二种癌症的风险增加，20年后分别超过61%和34%。相比之下，在卵巢癌患者中，第二种癌症的风险随着时间的推移而下降，10年后降至41%。与吸烟有关的癌症，即，宫颈癌患者口腔咽部、食管和呼吸系统的放射性显著增加。观察到的这些第二种癌症的2 - 3倍风险与最近将宫颈癌与吸烟联系起来的证据一致，并且似乎太大而不可能是低社会经济地位的混淆因素。在每个妇科部位，通常观察到腹部器官（结肠、直肠、肾脏、膀胱、卵巢）第二种癌症的发生率增加。然而，只有直肠癌始终与第一原发癌的放射治疗有关。子宫体癌和卵巢癌后白血病发生率高，但宫颈癌后没有。主要的细胞类型是急性非淋巴细胞白血病，并且过量与子宫体癌的放疗和卵巢癌的化疗有关。乳腺癌和结肠癌在子宫体癌和卵巢癌之后增加，反之亦然，这支持了这些部位具有共同病因的观点，可能与饮食或激素因素有关。宫颈癌患者出现了随后的乳腺癌缺陷，可能是由于卵巢切除或放射消融。研究人员需要进一步探索吸烟相关的癌症部位和宫颈癌之间的关联，以澄清放疗和化疗在过度癌症中的作用，并更充分地定义乳腺癌，结肠癌，子宫体癌和卵巢癌之间的病因学因素。
The risk of second primary cancer was evaluated in more than 25,000 women with cancer of the genital organs diagnosed between 1935 and 1982 in Connecticut. Significant excesses of subsequent cancers were observed following cancers of the cervix (35%, n = 656), uterine corpus (16%, n = 1,060), and ovary (58%, n = 366). When observed and expected second cancers of the female genital tract were excluded, these excesses became 40%, 30%, and 59% after cervix, uterine corpus, and ovary, respectively. Among women with either cancer of the cervix or uterine corpus, the risk of developing a second cancer rose with increasing duration of follow-up, reaching an excess of 61 and 34%, respectively, after 20 years. In contrast, among patients with ovarian cancer, the second cancer risk decreased over time to 41% after 10 years. Cancers related to smoking, i.e., oral cavity and pharynx, esophagus, and respiratory system, were notably increased among cervical cancer patients. The twofold to threefold risks observed for these second cancers are consistent with recent evidence linking cervical cancer to cigarette smoking and seem too large to be artifacts of confounding by low socioeconomic status. An increased incidence of second cancer of the abdominal organs (colon, rectum, kidney, bladder, ovaries) was generally observed for each gynecologic site. However, only rectal cancer was consistently linked with radiation treatment for the first primary cancer. Leukemia occurred in excess after cancers of the uterine corpus and ovary, but not after cervical cancer. The predominant cell type was acute nonlymphocytic leukemia, and the excess was associated with radiotherapy for uterine corpus cancer and with chemotherapy for ovarian cancer. Cancers of the breast and colon were increased following uterine corpus and ovarian cancer and vice versa, which supports the notion that these sites share a common etiology, perhaps related to dietary or hormonal factors. Cervical cancer patients experienced a deficit of subsequent breast cancer, possibly due to ovarian removal or ablation by radiation. Investigators need to explore further the association between the smoking-related cancer sites and cervical cancer, to clarify the role of radiotherapy and chemotherapy in relation to excess cancers, and to define more fully the etiologic factors that link cancers of the breast, colon, uterine corpus, and ovary.