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Annals of Oncology Advance Access published online on January 30, 2008
Annals of Oncology, doi:10.1093/annonc/mdn003
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© 2008 European Society for Medical Oncology. For Permissions, please email: journals.permissions@oxfordjournals.org

The incidence and risk of second primary cancers in patients with nasopharyngeal carcinoma: a population-based study in Taiwan over a 25-year period (1979–2003)

M.-C. Chen1, I.-J. Feng2, C.-H. Lu3,4, C.-C. Chen3,4, J.-T. Lin3,4, S.-H. Huang1 and K.-D. Lee3,4,*

1 Department of Public Health and Biostatistics Consulting Center, School of Medicine, Chang Gung University, Tao-Yuan, Taiwan
2 Department of Epidemiology and Biostatistics, Case Western Reserve University, Cleveland, Ohio, USA
3 Department of Hematology and Oncology, Chang Gung Memorial Hospital, Chiayi
4 Department of Nursing, Chang Gung Institute of Technology, Chiayi, Taiwan

* Correspondence to: Dr. K.-D. Lee, Department of Hematology and Oncology, Chang Gung Memorial Hospital, 6 West Sec, Chia-Pu Road, Pu-Tz city, Chiayi 613, Taiwan. Tel: +886-5-3621000 ext 2772; Fax: +886-5-3623781; E-mail: kdlee{at}adm.cgmh.org.tw

Background: Very few reports are available on the incidence and risk of second primary cancers in nasopharyngeal carcinoma (NPC) cases, and most of these are single-institution reviews with relatively small case numbers and short follow-up.

Patients and methods: A population-based study was conducted. We quantified standardized incidence ratios (SIRs) and cumulative incidence of second cancers among 23 639 individuals with initial diagnoses of NPC.

Results: We found a 24% increased risk of second cancers in NPC patients compared with the general population [SIR = 1.24, 95% confidence interval 1.15–1.33]. Elevated SIRs were observed in the following second primary cancers: oral/pharyngeal, salivary gland, sarcoma, skin and leukemia/lymphoma. The cumulative incidence >10 years was 3.26%. The risk was higher in younger patients, especially those <40 years old. After diagnosis of second cancers, the median survival time was 1.7 years.

Conclusions: This is the largest population-based study to date from a high-incidence area. We found that NPC is associated with an increased risk of second malignancies, which had a negative impact on the survival of patients who survived NPC.

cumulative incidence, nasopharyngeal carcinoma, second primary cancer

Received for publication November 30, 2007. Revision received December 25, 2007. Accepted for publication December 31, 2007.


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