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Multiple cancer--an epidemiologic exercise in Finland.
Journal of the National Cancer Institute
|August 1, 1985
Summary
This study analyzed multiple cancer occurrences in Finland, finding associations between cancers with similar causes, like smoking-related lung and larynx cancers. It also noted increased risks for some cancers based on prior diagnoses and patient demographics.
Area of Science:
- Epidemiology
- Oncology
- Public Health
Background:
- Understanding the occurrence of multiple primary cancers is crucial for cancer prevention and treatment.
- Previous research suggests shared risk factors and etiological pathways may link different cancer types.
- The Finnish Cancer Registry provides a robust dataset for investigating cancer patterns.
Purpose of the Study:
- To investigate the occurrence and patterns of multiple primary cancers using a large population-based registry.
- To identify associations between specific cancer types and explore potential shared risk factors.
- To analyze how age at diagnosis and follow-up duration influence the risk of subsequent cancers.
Main Methods:
- Analysis of data from the Finnish Cancer Registry (1953-1979) including 279,745 cancer patients.
- Identification of 5,871 new primary cancers occurring after the first diagnosis.
- Statistical analysis to assess relative risks and associations between different cancer types, considering factors like age and follow-up time.
Main Results:
- Positive associations observed between cancers with similar etiologies (e.g., lip, larynx, lung cancers due to smoking; breast and endometrial cancers due to hormonal factors).
- Clustering of risk factors led to excess risks (e.g., colon cancer in female breast cancer patients) and deficits (e.g., lung cancer in male colon cancer patients).
- Increased risk of leukemia noted in patients with breast, endometrial, and thyroid cancers; elevated salivary gland cancer risk in patients with non-melanoma/basal cell skin cancers.
Conclusions:
- Shared risk factors and etiological pathways significantly influence the occurrence of multiple primary cancers.
- Cancer risk patterns are influenced by demographic factors such as age at diagnosis and potentially by social class and irradiation.
- These findings highlight the importance of considering a patient's full cancer history and potential shared risk factors in clinical practice and research.