This study aims to investigate the relative risk of SPCs in cancer survivors in Switzerland combining data from all Swiss cantonal cancer registries with at least 15 years of consecutive incidence data

Arndt, Volker

Bordoni, Andrea

Bouchardy, Christine

Bulliard, Jean-Luc

Feller, Anita

Hermann, Christian

Konzelmann, Isabelle

Maspoli, Manuela

Matthes, Katarina L.

Mousavi, Mohsen

Rohrmann, Sabine

Staehelin, Katharina

English

Serveur académique lausannois

The relative risk of  second primary cancers in Switzerland Anita Feller1; Katarina L. Matthes2,3, Andrea Bordoni4; Christine Bouchardy5; Jean-Luc Bulliard6; Christian Hermann7,8, Isabelle Konzelmann9; Manuela Maspoli10; Mohsen Mousavi7,8; Sabine Rohrmann2,3, Katharina Staehelin11; Volker Arndt1,12, the NICER Working Group  1National Institute for Cancer Epidemiology and Registration (NICER), Zurich, CH;  2Cancer Registry Zurich and Zug, Zurich, CH; 3Epidemiology, Biostatistics and Prevention Institute, University of Zurich, CH; 4Ticino Cancer Registry, Locarno, CH; 5Geneva Cancer Registry, Geneva, CH; 6Vaud Cancer Registry, Lausanne, CH; 7Cancer Registry St. Gallen-Appenzell, St. Gallen, CH; 8Cancer Registry Grison & Glarus, Chur, CH; 9Valais Cancer Registry, , Sion, CH, 10Neuchâtel and Jura Cancer Registry, Neuchâtel, CH; 11Cancer Registry Basel-Stadt & Basel-Landschaft, Basel, CH; 12Unit of Cancer Survivorship, Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, DE 2. Aim • This study aims to investigate the relative risk of SPCs in cancer survivors in Switzerland combining data from all Swiss cantonal cancer registries with at least 15 years of consecutive incidence data.  4. Selected Results                                    6. References  1. Hayat MJ, Howlader N, Reichman ME, Edwards BK. Cancer statistics, trends, and multiple primary     cancer analyses  from the Surveillance, Epidemiology, and End Results (SEER) Program. The      oncologist. 2007;12(1):20-37. 2. Jegu J, Colonna M, Daubisse-Marliac L, Tretarre B, Ganry O, Guizard AV, et al. The effect of patient      characteristics on second primary cancer risk in France. BMC cancer. 2014;14:94. 3. Tabuchi T, Ito Y, Ioka A, Miyashiro I, Tsukuma H. Incidence of metachronous second primary cancers     in Osaka, Japan: update of analyses using population-based cancer registry data. Cancer science.       2012;103(6):1111-20. 4. Youlden DR, Baade PD. The relative risk of second primary cancers in Queensland, Australia: a     retrospective cohort study. BMC cancer. 2011;11:83. 5. Levi F, Randimbison L, Te VC, Rolland-Portal I, Franceschi S, La Vecchia C. Multiple primary cancers     in the Vaud Cancer Registry, Switzerland, 1974-89. Br J Cancer. 1993;67(2):391-5. 3. Methods Data source • This study used population-based cancer registry data from nine Swiss cantonal registries (incidence years 1981-2009) with a minimum survival of 6 months and a potential follow-up until the end of 2014 allowing a minimum of five years after initial diagnosis to ascertain the occurrence of a SPC (Ninitial cancers=310,113 ,NSPCs=33,793) Second primary tumour • A second primary tumour was defined as first subsequent primary cancer occurring at least 6 months after the first cancer. The definition of primary cancers followed the rules defined by the IACR/IARC. Statistical analyses • Incomplete or missing follow-up was addressed using multiple imputation with 25 imputations.  • The risk of second primary cancers was quantified using standardized incidence ratios (SIRs) for risk comparison with the general population.  5. Novelty and Impact • This is the first comprehensive investigation of SPC risks in Switzerland combining data from all longstanding Swiss cantonal cancer registries.  • Swiss cancer survivors have an increased risk of developing a SPC with the notable exception of patients with prostate cancer, female breast cancer and pancreatic  cancer. • Overall, the relative risk of SPCs is especially high in patients first diagnosed at younger ages (<50 years) and patients surviving 10 years or more. • Overall, the relative risk of SPCs is similar for males and females. • Cancer patients should remain under continued surveillance not only for recurrent cancers but also for new primary cancers. 1. Background • Currently, more people are living with a history of cancer than ever before and this increasing trend is likely to continue: one of the consequences of surviving cancer is the risk of being diagnosed with a second cancer.  • Previous studies showed that cancer survivors have an increased risk for being diagnosed with a second primary cancer (SPC) [1-4]. • The only systematic investigation of SPC risks in Switzerland is outdated and based on data from a single canton cancer registry covering less than 10% of the Swiss population [5]. First primary cancer 0-49 years 50-64 years 65+ years         O    SIR 95% CI          O SIR 95% CI             O SIR 95% CI Oral Cavity & Pharynx 403 6.61 (5.94-7.28) 1103 3.76 (3.54-3.99) 665 2.05 (1.89-2.21) Oesophagus 30 8.03 (4.80-11.25) 118 2.89 (2.33-3.44) 96 1.57 (1.24-1.91) Stomach 49 1.79 (1.24-2.34) 205 1.43 (1.22-1.63) 317 1.09 (0.96-1.21) Colorectal 251 1.81 (1.58-2.04) 1376 1.27 (1.20-1.34) 2814 1.09 (1.05-1.13) Liver 17 5.39 (2.40-8.37) 44 1.50 (1.01-1.99) 62 1.16 (0.85-1.47) Pancreas 4 1.14 (0.00-2.65) 37 1.61 (1.03-2.18) 51 0.97 (0.68-1.26) Larynx 91 3.56 (2.78-4.35) 470 2.94 (2.66-3.21) 332 1.88 (1.67-2.09) Lung 120 3.00 (2.43-3.57) 671 1.98 (1.82-2.13) 769 1.44 (1.34-1.55) Skin Melanoma 386 1.33 (1.19-1.46) 807 1.21 (1.12-1.29) 1083 1.20 (1.12-1.27) Breast female 748 0.98 (0.90-1.05) 2041 1.01 (0.96-1.05) 2356 0.96 (0.92-1.00) Cervix Uteri 169 1.63 (1.37-1.88) 163 1.75 (1.47-2.04) 126 1.43 (1.17-1.70) Corpus Uteri & NOS 90 1.66 (1.29-2.03) 581 1.26 (1.16-1.37) 650 1.13 (1.04-1.22) Ovary 74 1.56 (1.17-1.94) 155 1.30 (1.08-1.51) 138 1.11 (0.92-1.31) Prostate 17 1.15 (0.51-1.79) 1269 0.77 (0.72-0.81) 4352 0.75 (0.73-0.77) Testis 239 1.39 (1.21-1.58) 86 1.34 (1.03-1.64) 22 1.75 (0.91-2.59) Kidney 71 1.69 (1.27-2.12) 331 1.38 (1.23-1.54) 464 1.25 (1.14-1.37) Bladder 68 2.10 (1.56-2.64) 588 1.67 (1.53-1.81) 1087 1.39 (1.31-1.48) Brain & Central Nerves 51 2.05 (1.43-2.66) 43 1.24 (0.83-1.65) 19 0.99 (0.48-1.50) Thyroid 152 1.49 (1.24-1.74) 191 1.48 (1.26-1.70) 158 1.31 (1.09-1.53) Hodgkin Lymphoma 174 3.31 (2.79-3.83) 91 2.27 (1.77-2.77) 58 1.77 (1.27-2.26) Non Hodgkin Lymphoma 162 1.92 (1.61-2.23) 472 1.40 (1.27-1.53) 689 1.30 (1.20-1.40) Multiple Myeloma 14 1.30 (0.50-2.11) 85 1.14 (0.88-1.40) 194 1.13 (0.96-1.30) Leukaemia 96 2.43 (1.91-2.95) 334 1.70 (1.51-1.89) 528 1.40 (1.28-1.52)   All Cancers  3783 1.68 (1.62-1.73) 11920 1.32 (1.30-1.35) 18090 1.05 (1.04-1.07) First primary cancer 6 month - 1 year 1 year – 5 years 5 years - 10 years 10+ years       O  SIR 95% CI        O SIR 95% CI        O SIR 95% CI O SIR 95% CI Oral Cavity & Pharynx 166 3.28 (2.75-3.80) 971 3.54 (3.31-3.77) 636 3.18 (2.93-3.44) 398 2.59 (2.33-2.86) Oesophagus 30 1.78 (1.06-2.49) 131 2.51 (2.06-2.97) 47 1.97 (1.35-2.59) 36 2.82 (1.79-3.84) Stomach 46 0.98 (0.67-1.30) 205 1.09 (0.93-1.25) 163 1.34 (1.12-1.55) 157 1.48 (1.24-1.73) Colorectal 280 1.08 (0.95-1.21) 1671 1.10 (1.04-1.15) 1332 1.19 (1.13-1.26) 1158 1.29 (1.21-1.36) Liver 20 1.26 (0.62-1.89) 58 1.19 (0.85-1.52) 28 1.77 (1.03-2.52) 17 3.13 (1.40-4.87) Pancreas 18 0.87 (0.40-1.33) 45 1.15 (0.78-1.52) 16 1.30 (0.56-2.05) 13 1.86 (0.66-3.06) Larynx 53 2.61 (1.84-3.37) 361 2.77 (2.47-3.06) 256 2.34 (2.04-2.63) 223 2.19 (1.89-2.50) Lung 201 1.47 (1.26-1.69) 642 1.53 (1.41-1.65) 411 1.92 (1.73-2.11) 306 2.15 (1.90-2.40) Skin Melanoma 113 1.28 (1.03-1.52) 709 1.12 (1.04-1.21) 687 1.22 (1.13-1.32) 767 1.32 (1.22-1.41) Breast female 197 0.78 (0.67-0.90) 1532 0.85 (0.80-0.89) 1632 1.01 (0.96-1.06) 1784 1.14 (1.08-1.19) Cervix Uteri 16 1.31 (0.56-2.06) 108 1.45 (1.16-1.74) 124 1.69 (1.38-2.01) 210 1.68 (1.44-1.92) Corpus Uteri & NOS 46 0.95 (0.65-1.25) 386 1.15 (1.03-1.27) 359 1.12 (1.00-1.24) 530 1.37 (1.25-1.49) Ovary 20 0.86 (0.43-1.30) 105 0.93 (0.74-1.12) 102 1.36 (1.08-1.65) 140 1.75 (1.44-2.05) Prostate 348 0.68 (0.61-0.76) 2423 0.71 (0.68-0.74) 1868 0.76 (0.72-0.79) 999 0.91 (0.85-0.97) Testis 7 1.55 (0.10-3.00) 63 1.60 (1.17-2.03) 70 1.33 (0.99-1.67) 207 1.36 (1.17-1.56) Kidney 65 1.64 (1.21-2.07) 318 1.27 (1.12-1.41) 243 1.23 (1.07-1.39) 240 1.47 (1.27-1.66) Bladder 150 1.77 (1.47-2.06) 679 1.43 (1.32-1.54) 483 1.43 (1.30-1.56) 431 1.62 (1.46-1.78) Brain & Central Nerves 15 1.52 (0.62-2.43) 38 1.27 (0.82-1.72) 25 1.26 (0.70-1.82) 35 1.83 (1.15-2.50) Thyroid 20 1.46 (0.73-2.20) 151 1.46 (1.22-1.71) 125 1.20 (0.98-1.42) 205 1.57 (1.34-1.80) Hodgkin Lymphoma 8 1.53 (0.21-2.85) 99 2.89 (2.28-3.49) 70 2.09 (1.56-2.62) 146 2.78 (2.30-3.26) Non Hodgkin Lymphoma 81 1.26 (0.97-1.56) 494 1.27 (1.16-1.39) 401 1.40 (1.26-1.54) 347 1.62 (1.44-1.79) Multiple Myeloma 21 0.75 (0.38-1.12) 145 1.04 (0.86-1.21) 91 1.44 (1.13-1.76) 36 1.38 (0.88-1.88) Leukaemia 51 1.14 (0.80-1.48) 381 1.43 (1.29-1.58) 308 1.68 (1.49-1.88) 218 1.83 (1.57-2.08)   All Cancers  2098 1.10 (1.06-1.15) 12532 1.11 (1.09-1.13) 10011 1.17 (1.15-1.19) 9152 1.36 (1.34-1.39) Fig. 1: Relative risk of second primary cancers by first primary cancer and sex   Table 1: Relative risk of second primary cancers by first primary cancer and age  Table 2: Relative risk of second primary cancers by first primary cancer and follow-up period Please contact anita.feller@nicer.org for more information in this or related projects. O: Observed numbers of SPCs O: Observed numbers of SPCs 

The relative risk of second primary cancers in Switzerland

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The relative risk of second primary cancers in Switzerland

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