Incidence of second primary malignancies following colorectal cancer: A distinct pattern of occurrence between colon and rectal cancers and association of co-morbidity with second primary malignancies in a population-based cohort of 98,876 patients in Taiwan

Yu Ting Lee, Chia Jen Liu*, Yu Wen Hu, Chung Jen Teng, Cheng Hwai Tzeng, Chiu Mei Yeh, Tzeng Ji Chen, Jen Kou Lin, Chun Chi Lin, Yuan Tzu Lan, Huann Sheng Wang, Shung Haur Yang, Jeng Kai Jiang, Wei Shone Chen, Tzu Chen Lin, Shih Ching Chang, Ming Huang Chen, Hao Wei Teng, Jin Hwang Liu, Chueh Chuan Yen

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

27 Scopus citations

Abstract

The purpose of this study is to determine the features of second primary malignancies (SPMs) among patients with prior colorectal cancer (CRC) using a nationwide population-based dataset. Patients with CRC newly diagnosed between 1996 and 2011, and <1 year of follow-up were recruited from the Taiwan National Health Insurance database. Standardized incidence ratios (SIRs) of SPMs in patients with CRC were calculated. During the 16-year study period, 4259 SPMs developed among 98,876 CRC patients.The median duration of follow-up was 4.03 years. The SIR for all SPMs was 1.13 (95% confidence interval=1.10-1.17). Compared with the general population, a higher incidence of thyroid, prostate, ovarian, and hematologic malignancies developed among patients with colon cancer, whereas the risk for bone and soft tissue cancers increased among patients with rectal cancer. The risk for breast, bladder, kidney, lung, and uterine cancers was significantly higher in patients with colon and rectal cancers than the general population. The risk for liver and biliary tract cancers declined in patients with rectal cancer. Based on multivariate analysis among patients with CRC, age 70 years, men, chronic obstructive pulmonary disease (COPD), cirrhosis, and dyslipidemia were independent predictors of an SPM. In conclusion, patients with CRC were at increased risk for a second cancer. The pattern of SPMs was distinct between patients with colon and rectal cancer. Age, men, COPD, cirrhosis, and dyslipidemia were independent risk factors for SPMs. Surveillance and education should be provided for survivors with respect to risk for SPMs.

Original languageEnglish
Article numbere1079
JournalMedicine (United States)
Volume94
Issue number26
DOIs
StatePublished - 1 Jul 2015

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