Multiple primary tumors involving cancer of the brain and central nervous system as the first or subsequent cancer
Multiple primary tumors involving cancer of the brain and central nervous system as the first or subsequent cancer
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DOI：
10.1002/cncr.11554
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发表时间：
2003-08-01
期刊：
影响因子：
6.2
通讯作者：
Inskip, PD
中科院分区：
文献类型：
--
作者：
Inskip, PD
背景本研究旨在确定脑和中枢神经系统（CNS）癌症是否与其他类型的癌症一起发生，是否比预期的更频繁或更少。这项研究是基于1973年至1998年美国诊断的癌症的监测、流行病学和最终结果（SEER）计划收集的数据。新发恶性肿瘤的标准化发病率（SIR）估计为诊断为特定类型癌症的患者数量（观察到的）除以基于SEER癌症登记的随访人年和发病率的预期诊断数量。在首次诊断为脑癌或中枢神经系统癌症的患者中，观察到骨癌的统计学显著过量（SIR = 14.4），软组织（SIR = 4.6），脑和CNS（SIR = 5.9），唾液腺（SIR = 5.1）和甲状腺（SIR = 2.7）以及急性髓细胞白血病（SIR = 4.1）和皮肤黑色素瘤（SIR = 1.7）。在儿童时期首次诊断出脑癌或中枢神经系统癌症后，新发恶性肿瘤的额外风险明显高于成年期的类似诊断。在反向关联中，只有在诊断为急性淋巴细胞白血病（SIR = 7.4）和睾丸癌（SIR = 1.8）或甲状腺癌（SIR = 1.7）后，才观察到脑癌和CNS癌的显著过度。癌症治疗似乎是脑癌和其他类型原发性癌症之间大多数正相关的主要因素，共同的遗传易感性可能贡献较小。结果提供很少或没有证据表明脑癌与成人常见癌症有重要的病因学因素。2003年由美国癌症协会出版。
BACKGROUND. This study was undertaken to determine whether cancer of the brain and central nervous system (CNS) occurs together with other types of cancer more often or less often than would be expected due to chance.METHODS. The study was based on data collected by the Surveillance, Epidemiology, and End Results (SEER) Program for cancers diagnosed in the U.S. between 1973 and 1998. The standardized incidence ratio (SIR) for new malignancies was estimated as the number of patients diagnosed with a particular type of cancer (observed), divided by the number of diagnoses expected based on person-years of follow-up and incidence rates for SEER cancer registries.RESULTS. Among patients who were diagnosed first with cancer of the brain or CNS, statistically significant excesses were observed for cancers of bone (SIR = 14.4), soft tissue (SIR = 4.6), brain and CNS (SIR = 5.9), salivary gland (SIR 5.1), and thyroid gland (SIR = 2.7) in addition to acute myelocytic leukemia (SIR 4.1) and melanoma of the skin (SIR = 1.7). Excess risk of new malignancies was markedly greater after first cancers of the brain or CNS diagnosed in childhood compared with similar diagnoses in adulthood. In reverse associations, significant excesses of cancer of the brain and CNS were observed only after diagnoses of acute lymphocytic leukemia (SIR = 7.4) and cancer of the testis (SIR = 1.8) or the thyroid gland (SIR = 1.7).CONCLUSIONS. Cancer treatment appears to have been the major factor underlying most of the positive associations between brain cancer and primary cancers of other types, with a probable lesser contribution from shared genetic susceptibility. Results provide little or no evidence that brain cancer shares important etiologic factors with the common cancers of adulthood. Published 2003 by the American Cancer Society.*.