Epidemiology of Cancer Recurrence, Second Primary Cancer, and Comorbidity Among Cancer Survivors

Abstract Background The organisation of cancer follow-up is under scrutiny in many countries, and general practice is suggested to become more involved. A central focus is timely detection of recurring previous cancer and new second primary cancer. More knowledge on the patient pathway before cancer recurrence and second primary cancer is warranted to ensure the best possible organisation of follow-up. We aimed to describe the healthcare utilisation in the year preceding a diagnosis of cancer recurrence or second primary cancer. Methods This nationwide register study comprises patients diagnosed with bladder, breast, colorectal, endometrial, lung, malignant melanoma and ovarian cancer in Denmark in 2008–2016. The frequency of healthcare contacts during the 12 months preceding a cancer recurrence or second primary cancer was estimated and compared to the frequency of cancer survivors in cancer remission. The main analyses were stratified on sex and healthcare setting. Furthermore, two sub-analyses were stratified on 1) sex, healthcare setting and age group and on 2) sex, healthcare setting and comorbidity status. Results The study population consisted of 7832 patients with recurrence and 2703 patients with second primary cancer. On average, the patients were in contact with general practice one time per month in the 12th month preceding a new cancer diagnosis (recurrence or second primary cancer). Increasing contact rates were seen from 7 months before diagnosis in general practice and from 12 months before diagnosis in hospitals. This pattern was more pronounced in patients with cancer recurrence, younger patients and patients with no comorbidity. For instance, the contact rate ratios for hospital contacts in non-comorbid women with recurrence demonstrated 30% more contacts in the 12th month before recurrence and 127% more contacts in the 2nd month before recurrence. Conclusions The results show that cancer survivors are already seen in general practice on a regular basis. The increasing contact rates before a diagnosis of cancer recurrence or second primary cancer indicate that a window of opportunity exists for more timely diagnosis; this is seen in both general practice and in hospitals. Thus, cancer survivors may benefit from improvements in the organisation of cancer follow-up.

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A Path Analysis on Factors Influencing Second Primary Cancer Screening Practices in Stomach, Colon, and Breast Cancer Survivors

Journal of Korean Academy of Nursing ◽

10.4040/jkan.2014.44.2.139 ◽

2014 ◽

Vol 44 (2) ◽

pp. 139 ◽

Cited By ~ 5

Author(s):

Young Hee Yang

Keyword(s):

Breast Cancer ◽

Cancer Screening ◽

Cancer Survivors ◽

Path Analysis ◽

Breast Cancer Survivors ◽

Second Primary ◽

Primary Cancer ◽

Second Primary Cancer ◽

Screening Practices ◽

Factors Influencing

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Development of a model to predict the 10-year cumulative risk of second primary cancer among cancer survivors

Cancer Epidemiology ◽

10.1016/j.canep.2017.01.001 ◽

2017 ◽

Vol 47 ◽

pp. 35-41 ◽

Cited By ~ 7

Author(s):

Marie Moitry ◽

Michel Velten ◽

Brigitte Trétarre ◽

Simona Bara ◽

Laetitia Daubisse-Marliac ◽

...

Keyword(s):

Cancer Survivors ◽

Cumulative Risk ◽

Second Primary ◽

Primary Cancer ◽

Second Primary Cancer

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Prediagnosis Smoking, Obesity, Insulin Resistance, and Second Primary Cancer Risk in Male Cancer Survivors: National Health Insurance Corporation Study

Journal of Clinical Oncology ◽

10.1200/jco.2006.10.3416 ◽

2007 ◽

Vol 25 (30) ◽

pp. 4835-4843 ◽

Cited By ~ 57

Author(s):

Sang Min Park ◽

Min Kyung Lim ◽

Kyu Won Jung ◽

Soon Ae Shin ◽

Keun-Young Yoo ◽

...

Keyword(s):

Risk Factors ◽

Insulin Resistance ◽

Health Insurance ◽

Cancer Survivors ◽

National Health Insurance ◽

National Health ◽

Smoking History ◽

Second Primary ◽

Primary Cancer ◽

Second Primary Cancer

Purpose Smoking, obesity, and insulin resistance are well-known risk factors for cancer, yet few epidemiology studies evaluate their role as risk factors for a second primary cancer (SPC). Patients and Methods We identified 14,181 men with a first cancer from the National Health Insurance Corporation Study cohort. We obtained data on fasting glucose level, body mass index (BMI), and smoking history from an enrollment interview (1996). We obtained SPC incidence data for 1996 through 2002 from the Korean Central Cancer Registry. We used the standard Poisson regression model to estimate the age- and multivariate-adjusted relative risk (RR) for SPCs in relation to smoking history, BMI, and insulin resistance before diagnosis. Results We observed 204 patients with SPC. The overall age-standardized incidence rate of SPC was 603.2 occurrences per 100,000 person-years, which was about 2.3 times higher than that of first cancer in the general male population. Multivariate regression revealed that lung (RR, 3.69; 95% CI, 1.35 to 10.09) and smoking-related (RR, 2.02; 95% CI, 1.02 to 4.03) SPCs were significantly associated with smoking. Obese patients (BMI ≥ 25 kg/m2) had significantly elevated RRs for colorectal (RR, 3.45; 95% CI, 1.50 to 7.93) and genitourinary (RR, 3.61; 95% CI, 1.36 to 9.54) SPCs. Patients with a fasting serum glucose concentration ≥ 126 mg/dL had a higher RR for hepatopancreatobiliary (RR, 3.33; 95% CI, 1.33 to 8.37) and smoking-related (1.93; 95% CI, 1.01 to 3.68) SPCs. Conclusion Prediagnosis smoking history, obesity, and insulin resistance were risk factors for several SPCs. These findings suggest that more thorough surveillance and screening for SPCs is needed for the cancer survivors with these risk factors.

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Development of second primary cancers in breast cancer survivors.

Journal of Clinical Oncology ◽

10.1200/jco.2016.34.3_suppl.257 ◽

2016 ◽

Vol 34 (3_suppl) ◽

pp. 257-257

Author(s):

Hong Kyu Jung ◽

Jihyoun Lee ◽

Zisun Kim ◽

Min Hyuk Lee ◽

Ilkyun Lee

Keyword(s):

Breast Cancer ◽

Endometrial Cancer ◽

Thyroid Cancer ◽

Cancer Survivors ◽

Breast Cancer Survivors ◽

Second Primary ◽

Primary Cancer ◽

Second Primary Cancer ◽

Breast Cancer Patients ◽

Second Primary Cancers

257 Background: Breast cancer survivors have slightly increased risk of second primary cancers. Importance of screening for second cancers has been raised due to increased survival in those populations. Not only having genetic risk such as BRCA mutation, but also treatment-related risk presents. The most common second primary cancer is breast cancer. Colon cancer, uterine cancer, and ovarian cancer showed increased cumulative incidence. In this study, we assessed development second primary cancers in breast cancer survivors. Methods: Medical record of breast cancer patients was reviewed retrospectively in three tertiary medical institutions. Available data of ICD-9 record after breast cancer diagnosis was evaluated. Diagnosis of second primary breast cancer was excluded in evaluation. Results: Since Jan 1989 to Jan 2014, available medical records were reviewed in breast cancer patients(N = 5880) in three institutions(one urban and the other two rural institutions). Cumulative incidence of overall second primary cancers was 4.57%. Among 269 second primary cancers, thyroid cancer(44.2%) was most common second primary cancer, followed by gastric cancer(10.0%). Gastric cancers were more common in rural institution than urban area(14.2 % vs 5.5%), while incidence of thyroid cancer is elevated in urban institution(57.8% vs 31.9%). Among 9 patients who has been diagnosed endometrial cancer, 7 patients had history of selective estrogen receptor modulator(tamoxifen or toremifen) treatment. Development of lung cancer was not related to breast cancer radiation treatment(4 of 15 patients). Leukemia after breast cancer treatment was diagnosed in 5 patients (8.5% of second primary cancers), three of them were adult T cell leukemia and two of them were acute myeloid leukemia. Conclusions: Incidence of cancer in general population was reflected to development of second primary cancer in breast cancer survivors. Endocrine treatment was related increased incidence of endometrial cancer, respectively. Application of personalized cancer screening plan would be important in this patient group.

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