Journal article
Association of first primary cancer with risk of subsequent primary cancer among survivors of adult-onset cancers in Kentucky and Appalachian Kentucky
Frontiers in oncology, Vol.13, 1193487
08/17/2023
DOI: 10.3389/fonc.2023.1193487
PMCID: PMC10470616
PMID: 37664066
Abstract
Background: Appalachia is a region with significant cancer disparities in incidence and mortality compared to Kentucky and the United States. However, the contribution of these cancer health disparities to subsequent primary cancers (SPCs) among survivors of adult-onset cancers is limited. This study aimed to quantify the overall and cancer type-specific risks of SPCs among adult-onset cancer survivors by first primary cancer (FPC) types, residence and sex.
Methods: This retrospective cohort study from the Kentucky Cancer Registry included 148,509 individuals aged 20-84 years diagnosed with FPCs from 2000-2014 (followed until December 31, 2019) and survived at least 5 years. Expected numbers of SPC were derived from incidence rates in the Kentucky population; standardized incidence ratio (SIR) compared with those expected in the general Kentucky population.
Results: Among 148,509 survivors (50.2% women, 27.9% Appalachian), 17,970 SPC cases occurred during 829,530 person-years of follow-up (mean, 5.6 years). Among men, the overall risk of developing any SPCs was statistically significantly higher for 20 of the 30 FPC types, as compared with risks in the general population. Among women, the overall risk of developing any SPCs was statistically significantly higher for 20 of the 31 FPC types, as compared to the general population. The highest overall SIR were estimated among oral cancer survivors (SIR, 2.14 [95% CI, 1.97-2.33] among men, and among laryngeal cancer survivors (SIR, 3.62 [95% CI, 2.93-4.42], among women. Appalachian survivors had significantly increased risk of overall SPC and different site specific SPC when compared to non-Appalachian survivors. The highest overall SIR were estimated among laryngeal cancer survivors for both Appalachian and non-Appalachian residents (SIR, 2.50: 95%CI, 2.10-2.95; SIR, 2.02: 95% CI, 1.77-2.03, respectively).
Conclusion: Among adult-onset cancer survivors in Kentucky, several FPC types were significantly associated with greater risk of developing an SPC, compared with the general population. Risk for Appalachian survivors was even higher when compared to non-Appalachian residents, but was not explained by higher risk of smoking related cancers. Cancers associated with smoking comprised substantial proportions of overall SPC incidence among all survivors and highlight the importance of ongoing surveillance and efforts to prevent new cancers among survivors.
Details
- Title: Subtitle
- Association of first primary cancer with risk of subsequent primary cancer among survivors of adult-onset cancers in Kentucky and Appalachian Kentucky
- Creators
- Quan Chen - Markey Cancer CenterBin Huang - Markey Cancer CenterAbigail M. Anderson - Markey Cancer CenterEric B. Durbin - Markey Cancer CenterSusanne M. Arnold - University of KentuckyJill M. Kolesar - University of Kentucky
- Resource Type
- Journal article
- Publication Details
- Frontiers in oncology, Vol.13, 1193487
- Publisher
- Frontiers Media Sa
- DOI
- 10.3389/fonc.2023.1193487
- PMID
- 37664066
- PMCID
- PMC10470616
- ISSN
- 2234-943X
- eISSN
- 2234-943X
- Number of pages
- 19
- Grant note
- This study was supported by Cancer research informatics and biostatistical and bioinformatics Shared Resource Facilities of the Markey Cancer Center, supported by the National Cancer Institute Support Grant (P30 CA177558). The authors confirm PMCID complia Cancer research informatics and biostatistical and bioinformatics Shared Resource Facilities of the Markey Cancer Center National Cancer Institute Support Grant; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Cancer Institute (NCI)
- Language
- English
- Date published
- 08/17/2023
- Academic Unit
- Pharmacy; Pharmaceutical Sciences and Experimental Therapeutics
- Record Identifier
- 9984696553402771
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