MedicalResearch.com Interview with:
Karim Chamie MD, MSHS
Department of Urology
Jonsson Comprehensive Cancer Center
David Geffen School of Medicine
University of California at Los Angeles
Los Angeles, California
MedicalResearch.com: What is the background for this study?
Response: With improved cancer outcomes, there are 14 million cancer survivors alive in the United States in 2012. That number is expected to increase to nearly 20 million by 2024. With such a large population, many of these cancer survivors are at risk for developing a second primary malignancy. Multiple primary cancers now account for approximately 17% of all incident cancers reported each year in the United States.
Cancer survivors may be especially susceptible to developing second primary malignancies due to a variety of unique factors, including genetic syndromes, common etiologic exposures, and the late effects of chemotherapy and radiotherapy. Given the longer duration of cancer survivorship and the substantial proportion of survivors at risk for developing second primary malignancies, the incidence and mortality from second primary malignancies are likely to increase.
MedicalResearch.com: What are the main findings?
Response: Of the 2,116,163 patients identified, we found that 170,865 (8.1%) developed a second primary malignancy. Bladder cancer survivors had the highest risk for a second cancer––34% with 20-year follow up. After adjusting for age, race, grade, stage, marital status, education, and income, a history of non-Hodgkin lymphoma and bladder cancer was associated with the highest risk for developing a second cancer. For patients with two incident cancers, 13% died from their initial cancer, but more than half (55%) died from their second primary malignancy. Lung cancer was the cause of death in 12% of patients with two incident cancers.
MedicalResearch.com: What should readers take away from your report?
Response: With improved cancer survivorship, clinicians should direct their attention to not only surveying patients for cancer recurrence, but also a new primary cancer. Also, we found that some patients are at increased risk of developing certain types of cancer, such as the association of a bladder primary and a lung cancer second primary. This association, for example in bladder and lung cancers, is likely related to exposures to certain carcinogens, such as tobacco use, however, it is also possible that some cancers may be linked by similarities in genetic instability.
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Risk of second primary malignancies among cancer survivors in the United States, 1992 through 2008
Nicholas Donin, Christopher Filson, Alexandra Drakaki, Hung-Jui Tan, Alex Castillo, Lorna Kwan, Mark Litwin and Karim Chamie
Version of Record online : 5 JUL 2016, DOI: 10.1002/cncr.30164
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