Time from incident primary cancer until recurrence or second primary cancer: Risk factors and impact in general practice

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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Estimation of Second Primary Cancer Risk After Treatment with Radioactive Iodine for Differentiated Thyroid Carcinoma

Thyroid ◽

10.1089/thy.2016.0266 ◽

2017 ◽

Vol 27 (2) ◽

pp. 261-270 ◽

Cited By ~ 2

Author(s):

Nilton Lavatori Corrêa ◽

Lidia Vasconcellos de Sá ◽

Rossana Corbo Ramalho de Mello

Keyword(s):

Cancer Risk ◽

Thyroid Carcinoma ◽

Radioactive Iodine ◽

Differentiated Thyroid Carcinoma ◽

Second Primary ◽

Primary Cancer ◽

Second Primary Cancer

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Risk factors and prediction of second primary cancer in primary female non-metastatic breast cancer survivors

Aging ◽

10.18632/aging.103939 ◽

2020 ◽

Vol 12 (19) ◽

pp. 19628-19640

Author(s):

Xiwen Qian ◽

Huixun Jia ◽

Yue Zhang ◽

Bingqing Ma ◽

Guoyou Qin ◽

...

Keyword(s):

Breast Cancer ◽

Risk Factors ◽

Metastatic Breast Cancer ◽

Cancer Survivors ◽

Breast Cancer Survivors ◽

Metastatic Breast ◽

Second Primary ◽

Primary Cancer ◽

Second Primary Cancer

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Healthcare utilisation in general practice and hospitals in the year preceding a diagnosis of cancer recurrence or second primary cancer: a population-based register study

BMC Health Services Research ◽

10.1186/s12913-019-4757-y ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 1

Author(s):

Linda Aagaard Rasmussen ◽

Henry Jensen ◽

Line Flytkjær Virgilsen ◽

Alina Zalounina Falborg ◽

Henrik Møller ◽

...

Keyword(s):

General Practice ◽

Cancer Survivors ◽

Cancer Recurrence ◽

Healthcare Utilisation ◽

Healthcare Setting ◽

Second Primary ◽

Primary Cancer ◽

Second Primary Cancer ◽

Diagnosis Of Cancer

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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