Colon cancer as a second primary cancer after endometrial cancer based on shared etiology

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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The association between histological subtype of a first primary endometrial cancer and second cancer risk

International Journal of Gynecological Cancer ◽

10.1136/ijgc-2018-000014 ◽

2018 ◽

Vol 29 (2) ◽

pp. 290-298

Author(s):

Jennifer Rhoades ◽

Monica Hagan Vetter ◽

James L Fisher ◽

David E Cohn ◽

Ritu Salani ◽

...

Keyword(s):

Endometrial Cancer ◽

General Population ◽

Cancer Risk ◽

Second Primary ◽

Low Grade ◽

Primary Cancer ◽

Histological Subtype ◽

Second Primary Cancer ◽

Histological Subtypes ◽

Cancer Risks

ObjectiveTo evaluate the risk of a second primary cancer after endometrial cancer according to histological subtype.MethodsUsing data from the 13 National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) registries we identified women diagnosed with a primary endometrial cancer between 1992 and 2014. We calculated standardized incidence ratios (SIRs) and 95% confidence intervals (CIs) for second primary cancer risk (all anatomical sites combined and for individual anatomical sites) among patients with endometrial cancer compared with the general population, in the overall study population and according to histological subtype.ResultsAmong 96 256 women diagnosed with endometrial cancer, 8.4% (n=8083) developed a second primary cancer. The risk of second primary cancer was higher among patients with endometrial cancer than in the general population (SIR=1.05, 95% CI 1.03 to 1.07). We observed significantly higher second primary cancer risk among women with high grade endometrioid (SIR=1.12, 95% CI 1.05 to 1.19), serous (SIR=1.24, 95% CI 1.11 to 1.38), carcinosarcoma (SIR=1.18, 95% CI 1.02 to 1.35), mixed epithelial (SIR=1.22, 95% CI 1.06 to 1.40), and sarcoma (SIR=1.28, 95% CI 1.12 to 1.45) compared with the general population, but not for women with low grade endometrioid (SIR=1.01, 95% CI 0.98 to 1.03) or clear cell (SIR=1.09, 95% CI 0.88 to 1.33) endometrial cancer. Women with low grade endometrioid endometrial cancer had significantly lower second primary cancer risks in the gum and other mouth (SIR=0.57, 95% CI 0.30 to 0.97), lung and bronchus (SIR=0.72, 95% CI 0.66 to 0.77), and lymphocytic leukemia (SIR=0.71, 95% CI 0.54 to 0.93) while women with high risk endometrial cancer histological subtypes experienced significantly higher second primary cancer risk at several anatomical sites.ConclusionsRisk of developing second primary cancersat all anatomic sites combined and at individual anatomical sites varied according to histological subtype. Clinicians should be aware that women with different histological subtypes carry different second primary cancer risks .

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