米国における成人発がんの生存者における最初の原発がんと後の原発がんのリスクとの関連
Hyuna Sung1, Noorie Hyun2, Corinne R Leach3
1Department of Data Science, American Cancer Society, Atlanta, Georgia.
JAMA
|December 22, 2020
まとめ
がんを生き延びた人は,次の原発性がん (SPC) のリスクが高く,特定の最初の原発性がんのタイプと女性ではリスクが高く見られる. 喫煙や肥満のような生活習慣の要因は,SPCの発生率と死亡率に大きく寄与しています.
科学分野:
- 腫瘍学
- ガン 流行 病学
- 公衆衛生
背景:
- 癌の生存者における後期原発がん (SPC) の発生率は増加しているが,これらのリスクに関する包括的なデータは限られている.
- これらのリスクを理解することは 長期的な生存ケアと癌予防戦略の改善に不可欠です
研究 の 目的:
- 成人発がんの生存者におけるSPCによる発症および死亡の全体的および特定がんのリスクを定量化する.
- 最初の原発がん (FPC) の種類と性別に基づいてこれらのリスクを分析する.
主な方法:
- 12の米国監視,流行病学,最終結果 (SEER) レジストリからのデータを利用した遡及コホート研究.
- 1992年から2011年の間に診断された1,537,101人の成人がん生存者を含め,2017年12月31日まで追跡され,診断後の生存期間は最低5年であった.
- SPCの発生率と死亡率は,標準化された発生率 (SIR) と標準化された死亡率 (SMR) を用いて評価された.
主要な成果:
- 生存者は,FPCのタイプと性別によって,一般の人々と比較して,SPCから発症し死亡するリスクが著しく高かった.
- 男性では,FPC型18種でSPCの発症リスクが増加し,27種で死亡リスクが増加した. 女性では,21のFPC型でSPCの発症リスクが増加し,28のFPC型で死亡リスクが増加した.
- 男性における喉癌と胆管癌,女性における喉癌のリスクは最も高かった. 肺がんはSPC死亡率の主要な要因であった (31-33%).
結論:
- いくつかの原発がんは 後に発症するがんのリスクを大幅に高め, 生き残った患者の死亡率を高めます.
- 喫煙と肥満に関連した癌は,全体的なSPC負担に大きく貢献しています.
- 癌の生存者に対する継続的な監視と標的型予防の必要性を強調する.
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