The effect of patient characteristics on second primary cancer risk in France

BMC Cancer

Michel Velten¹  Anne-Sophie Woronoff⁸  Véronique Bouvier⁸  Xavier Troussard⁸  Simona Bara²  Anne-Valérie Guizard⁴  Olivier Ganry⁶  Brigitte Trétarre³  Laetitia Daubisse-Marliac⁷  Marc Colonna⁵  Jérémie Jégu¹ 

[1]Service de santé publique, Hôpitaux Universitaires de Strasbourg, 1 place de l’hôpital, Strasbourg, CEDEX 67091, France

[2]Registre des cancers de la Manche, Centre Hospitalier Public du Cotentin, 46 rue du Val de Saire, Cherbourg-Octeville 50102, France

[3]Registre des tumeurs de l’Hérault, Centre de Recherche, 208 rue des Apothicaires, Montpellier, CEDEX 5 34298, France

[4]Registre général des tumeurs du Calvados, Cancers & Préventions - U 1086 Inserm, Centre François Baclesse, Avenue du Général Harris BP 5026, Caen, CEDEX 05 14076, France

[5]Registre des cancers de l’Isère, CHU de Grenoble, Pavillon E BP 217, Grenoble, CEDEX 9 38043, France

[6]Registre des cancers de la Somme, Service Épidémiologie Hygiène et Santé Publique, CHU Nord, Amiens, CEDEX 1 80054, France

[7]Institut Claudius Regaud, 20–24, rue du Pont-Saint-Pierre, Toulouse cedex 31052, France

[8]Francim : Réseau français des registres des cancers, Toulouse F-31073, France

关键词: France;    Registries;    Multivariate analysis;    Risk assessment;    Second primary;    Neoplasms;   

Others  :  859063
DOI  :  10.1186/1471-2407-14-94

 received in 2013-07-01, accepted in 2014-02-12,  发布年份 2014

【 摘 要 】

Background

Although cancer survivors are known to be at greater risk of developing second primary cancer (SPC), SPC incidence estimates in France are thus far lacking. We used a multivariate approach to compute these estimates and analyzed the effect of patient characteristics (gender, age at diagnosis, first cancer site, year of diagnosis and follow-up) on SPC risk.

Methods

Data from ten French population-based cancer registries were used to establish a cohort of all patients diagnosed with a first cancer between 1989 and 2004 and followed up until December 31, 2007. The person-year approach was used to estimate standardized incidence ratios (SIRs) and excess absolute risks (EARs) of metachronous SPC. Multivariate Poisson regression models were then used to model SIRs and EARs separately by gender, adjusting for age, year of diagnosis, follow-up and first cancer site.

Results

Among the 289,967 followed-up patients with a first primary cancer, 21,226 developed a SPC. The SIR was of 1.36 (95% CI, 1.35-1.38) and the EAR was of 39.4 excess cancers per 10,000 person-years (95% CI, 37.4-41.3). Among male and female patients, multivariate analyses showed that age, year of diagnosis, follow-up and first cancer site were often independently associated with SIRs and EARs. Moreover, the EAR of SPC remained elevated during patient follow-up.

Conclusions

French cancer survivors face a dramatically increased risk of SPC which is probably related to the high rate of tobacco and alcohol consumption in France. Multivariate modeling of SPC risk will facilitate the construction of a tailored prediction tool to optimize SPC prevention and early detection strategies.

【 授权许可】

   
2014 Jégu et al.; licensee BioMed Central Ltd.

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