Racial and Ethnic Disparities in Second Primary Lung Cancer After Breast Radiotherapy: A SEER Cohort Analysis...

Area of Science:

• Oncology
• Public Health
• Epidemiology

Background:

• Adjuvant radiation therapy for breast cancer improves survival but poses a risk of second primary lung cancer (SPLC).
• Racial, ethnic, and social disparities in SPLC risk among breast cancer survivors are not well understood.

Purpose of the Study:

• To quantify racial and ethnic differences in SPLC incidence and survival.
• To investigate the role of marital status in SPLC risk and survival.

Main Methods:

• Utilized SEER-17 data (2000-2022) for breast cancer patients receiving radiotherapy.
• Calculated standardized incidence ratios (SIRs) for SPLC by race/ethnicity and marital status.
• Assessed five-year overall survival (OS) post-SPLC and mean age at death.

Main Results:

• SPLC risk varied significantly by race; American Indian/Alaska Native (AI/AN) patients had the highest risk (SIR 1.82).
• Black and Asian/Pacific Islander (API) survivors had sustained elevated SPLC risk, while White and Hispanic survivors had lower risk.
• Married individuals had 12% lower SPLC incidence (SIR 0.88) and improved OS (31.8% vs. 25.0%) compared to unmarried patients.

Conclusions:

• SPLC risk and outcomes after breast radiotherapy are influenced by race, ethnicity, and marital status.
• Findings underscore the need for tailored survivorship counseling and personalized lung cancer screening for breast cancer survivors.
• Addressing disparities in SPLC risk and survival is crucial for improving long-term outcomes.