在美国的成人癌症幸存者中,第一个原发性癌症与随后的原发性癌症风险的关联
Hyuna Sung1, Noorie Hyun2, Corinne R Leach3
1Department of Data Science, American Cancer Society, Atlanta, Georgia.
JAMA
|December 22, 2020
概括
癌症幸存者面临患上后续原发性癌症 (SPC) 的风险增加,对于特定的第一个原发性癌症类型和女性而言,风险更高. 吸烟和肥胖等生活方式因素对SPC发病率和死亡率有很大影响.
科学领域:
- 癌症学
- 癌症流行病学
- 公共卫生
背景情况:
- 癌症幸存者的后续原发性癌症 (SPC) 发生率正在上升,但关于这些风险的综合数据有限.
- 了解这些风险对于改善长期生存护理和癌症预防策略至关重要.
研究的目的:
- 在成人癌症幸存者中量化SPC的发展和死亡的整体和癌症类型的风险.
- 根据第一个原发性癌症 (FPC) 和性别分析这些风险.
主要方法:
- 一个回顾性队列研究,利用12个美国监测,流行病学和最终结果 (SEER) 注册表的数据.
- 包括1992年至2011年间诊断的1,537,101名成年癌症幸存者,在诊断后至少存活5年.
- 与一般人群相比,使用标准化发病率 (SIR) 和标准化死亡率 (SMR) 来评估SPC的发病率和死亡率.
主要成果:
- 与一般人群相比,幸存者患上SPC和死亡的风险显著增加,FPC类型和性别有所不同.
- 在男性中,18种FPC类型显示增加SPC发育风险,27种显示增加死亡风险. 在女性中,21种FPC类型显示增加SPC发育风险,28种显示增加死亡风险.
- 男性的喉癌和胆囊癌以及女性的喉癌的风险最高. 肺癌是SPC死亡的主要原因 (31-33%).
结论:
- 几种原发性癌症显著增加了幸存者的后续癌症和相关死亡率的风险.
- 与吸烟和肥胖相关的癌症是导致整体SPC负担的重要因素.
- 强调需要对癌症幸存者进行持续的监测和有针对性的预防工作.
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