A population-based study of subsequent primary malignancies after endometrial cancer: genetic, environmental, and treatment-related associations

To examine the risk of subsequent primary malignancies (SPMs) in women diagnosed with endometrial cancer. The National Cancer Institute's Survival, Epidemiology, and End Results database was used to determine the risk of SPM after endometrial cancer in 69,739 women diagnosed between 1973 and 20...

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Bibliographic Details
Published in:International journal of radiation oncology, biology, physics Vol. 78; no. 1; p. 127
Main Authors: Brown, Aaron P, Neeley, E Shannon, Werner, Theresa, Soisson, Andrew Patrick, Burt, Randall W, Gaffney, David K
Format: Journal Article
Language:English
Published: United States 01.09.2010
Subjects:
Adolescent
Adult
Age Factors
Aged
Aged, 80 and over
Bone Neoplasms - epidemiology
Bone Neoplasms - etiology
Bone Neoplasms - genetics
Colonic Neoplasms - epidemiology
Colonic Neoplasms - etiology
Colonic Neoplasms - genetics
Endometrial Neoplasms - genetics
Endometrial Neoplasms - radiotherapy
Esophageal Neoplasms - epidemiology
Esophageal Neoplasms - etiology
Esophageal Neoplasms - genetics
Female
Follow-Up Studies
Humans
Incidence
Intestinal Neoplasms - epidemiology
Intestinal Neoplasms - etiology
Intestinal Neoplasms - genetics
Intestine, Small - radiation effects
Lung Neoplasms - epidemiology
Lung Neoplasms - etiology
Lung Neoplasms - genetics
Middle Aged
Mouth Neoplasms - epidemiology
Mouth Neoplasms - etiology
Mouth Neoplasms - genetics
Neoplasms, Radiation-Induced - epidemiology
Neoplasms, Radiation-Induced - etiology
Neoplasms, Radiation-Induced - genetics
Neoplasms, Second Primary - epidemiology
Neoplasms, Second Primary - etiology
Neoplasms, Second Primary - genetics
Pharyngeal Neoplasms - epidemiology
Pharyngeal Neoplasms - etiology
Pharyngeal Neoplasms - genetics
Risk Assessment
SEER Program
United States - epidemiology
Urinary Bladder Neoplasms - epidemiology
Urinary Bladder Neoplasms - etiology
Urinary Bladder Neoplasms - genetics
Vaginal Neoplasms - epidemiology
Vaginal Neoplasms - etiology
Vaginal Neoplasms - genetics
Young Adult
United States
ISSN:1879-355X, 1879-355X
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Summary:To examine the risk of subsequent primary malignancies (SPMs) in women diagnosed with endometrial cancer. The National Cancer Institute's Survival, Epidemiology, and End Results database was used to determine the risk of SPM after endometrial cancer in 69,739 women diagnosed between 1973 and 2005. Standardized incidence ratios were calculated (observed/expected [O/E]) for SPM sites. Median follow-up was 11.2 years, representing 757,567 person-years of follow-up. The risk of SPM was significantly increased for small intestine (O/E = 1.48; 99% confidence interval [CI], 1.03-2.05), colon (O/E = 1.16; CI, 1.09-1.24), vagina (O/E = 2.71; CI, 1.86-3.8), and urinary bladder (O/E = 1.41; CI, 1.25-1.59) SPMs and decreased for oral cavity and pharynx (O/E = 0.75; CI, 0.6-0.93), lung and bronchus (O/E = 0.78; CI, 0.72-0.84), and esophagus (O/E = 0.58; CI, 0.37-0.86) SPMs. Patients receiving external-beam radiotherapy for endometrial cancer had an increased risk of colon (p < 0.001), bladder (p < 0.001), vagina (p = 0.04), and soft-tissue (p = 0.014) SPMs. Patients treated with brachytherapy had an increased risk of bladder SPM (p = 0.006). A positive bidirectional association with endometrial cancer was observed for colorectal cancer, with a negative bidirectional association for oropharyngeal and lung cancers. Genetic, environmental, and treatment-related factors influence SPM risk. Genetic factors may contribute to the increased risk of colorectal cancer. Smoking's negative effect on endometrial cancer risk factors might explain the decreased risk of lung and oropharyngeal cancer. Patients treated with radiotherapy likely have a small but significantly increased risk of bladder, vagina, colon, and soft-tissue SPM.
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ISSN:1879-355X
1879-355X
DOI:10.1016/j.ijrobp.2009.07.1692