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Updated: Jan 11, 2026
06:46
Competing-Risk Nomogram for Predicting Cancer-Specific Survival in Multiple Primary Colorectal Cancer Patients after Surgery
Published on: September 27, 2024
633
Multiple Primary Cancer Incidence by County-Level Smoking Prevalence among U.S. Cancer Survivors
Hui G Cheng1, Susan Hong1,2, Oxana Palesh1,3
1Massey Comprehensive Cancer Center, Virginia Commonwealth University, Richmond, Virginia.
Summary
Higher smoking prevalence in counties is linked to increased multiple primary cancer (MPC) incidence. Targeted community tobacco control can help reduce the risk of developing additional cancers.
Area of Science:
- Oncology
- Public Health
- Epidemiology
Background:
- Multiple primary cancer (MPC) is a growing public health concern with increasing cancer survivor numbers.
- Understanding geographic variations in MPC incidence is crucial for developing targeted public health strategies.
- This study investigates the link between county-level cigarette smoking prevalence and MPC incidence.
Purpose of the Study:
- To examine the association between county-level smoking prevalence and the incidence of multiple primary cancers (MPC).
- To inform public health strategies and community-level interventions for tobacco control.
Main Methods:
- Retrospective cohort study using data from the Surveillance, Epidemiology, and End Results (SEER) 17 registries (2000-2021).
- Cohort included 6,364,027 individuals diagnosed with an initial primary cancer.
- Analyzed MPC incidence using observed-to-expected ratios across strata of county-level smoking prevalence, stratified by sex, age, and race/ethnicity.
Main Results:
- A positive association was observed between higher county-level smoking prevalence and MPC incidence.
- Observed-to-expected ratios for MPC increased with smoking prevalence, particularly in females.
- The association was robust among individuals diagnosed with their initial cancer between ages 45 and 64.
Conclusions:
- County-level smoking prevalence is a significant factor associated with increased MPC incidence.
- Findings underscore the need for targeted, community-level tobacco control interventions to mitigate MPC risk.
- Community-level data can identify high-risk populations for tobacco control and cancer survivorship interventions.
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