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Subsequent cancers in patients diagnosed with cancer of unknown primary (CUP): etiological insights?

Shu, Xiaochen LU ; Liu, Hao LU ; Ji, Jianguang LU ; Sundquist, Kristina LU ; Försti, Asta LU ; Sundquist, Jan LU and Hemminki, Kari LU (2012) In Annals of Oncology 23. p.269-275
Abstract
BACKGROUND: Patterns of subsequent malignancies in patients with cancer of unknown primary (CUP) may provide etiological insight into the primary tumor. The objective of the present study is to quantify risks of the subsequent cancers in CUP patients since such studies are lacking. PATIENTS AND METHODS: A population-based cohort of CUP was identified from the Swedish Family-Cancer Database of year 2008. Standardized incidence ratios (SIRs) were calculated for developing the following malignancies in 31 357 CUP patients from 1975 to 2008. RESULTS: A total of 755 CUP patients developed subsequent cancers, showing a significantly increased overall SIR of 1.69 (95% confidence interval 1.57-1.81). Among the most common 32 malignancies,... (More)
BACKGROUND: Patterns of subsequent malignancies in patients with cancer of unknown primary (CUP) may provide etiological insight into the primary tumor. The objective of the present study is to quantify risks of the subsequent cancers in CUP patients since such studies are lacking. PATIENTS AND METHODS: A population-based cohort of CUP was identified from the Swedish Family-Cancer Database of year 2008. Standardized incidence ratios (SIRs) were calculated for developing the following malignancies in 31 357 CUP patients from 1975 to 2008. RESULTS: A total of 755 CUP patients developed subsequent cancers, showing a significantly increased overall SIR of 1.69 (95% confidence interval 1.57-1.81). Among the most common 32 malignancies, increased SIRs were noted for 16 sites. Over 10-fold increases were observed for squamous cell carcinoma at four sites, possibly as a result of uncontrolled human papillomavirus infection due to faltering immune surveillance. The highest SIRs were observed among CUP patients diagnosed at a younger age and during the first follow-up year. CONCLUSIONS: Swedish CUP survivors had a higher risk of developing many subsequent cancers. Different patterns of risk excess may be suggestive of possible roles for disease- and therapy-related immunosuppression, reappearance of hidden primary tumors, or genetic predisposition. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Annals of Oncology
volume
23
pages
269 - 275
publisher
Oxford University Press
external identifiers
  • WOS:000298385300040
  • PMID:21450937
  • Scopus:79957846972
ISSN
1569-8041
DOI
10.1093/annonc/mdr059
language
English
LU publication?
yes
id
11748194-3caf-4cb7-b4f3-0ac6c425d435 (old id 1937707)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/21450937?dopt=Abstract
date added to LUP
2011-05-02 08:43:11
date last changed
2016-11-10 15:57:03
@misc{11748194-3caf-4cb7-b4f3-0ac6c425d435,
  abstract     = {BACKGROUND: Patterns of subsequent malignancies in patients with cancer of unknown primary (CUP) may provide etiological insight into the primary tumor. The objective of the present study is to quantify risks of the subsequent cancers in CUP patients since such studies are lacking. PATIENTS AND METHODS: A population-based cohort of CUP was identified from the Swedish Family-Cancer Database of year 2008. Standardized incidence ratios (SIRs) were calculated for developing the following malignancies in 31 357 CUP patients from 1975 to 2008. RESULTS: A total of 755 CUP patients developed subsequent cancers, showing a significantly increased overall SIR of 1.69 (95% confidence interval 1.57-1.81). Among the most common 32 malignancies, increased SIRs were noted for 16 sites. Over 10-fold increases were observed for squamous cell carcinoma at four sites, possibly as a result of uncontrolled human papillomavirus infection due to faltering immune surveillance. The highest SIRs were observed among CUP patients diagnosed at a younger age and during the first follow-up year. CONCLUSIONS: Swedish CUP survivors had a higher risk of developing many subsequent cancers. Different patterns of risk excess may be suggestive of possible roles for disease- and therapy-related immunosuppression, reappearance of hidden primary tumors, or genetic predisposition.},
  author       = {Shu, Xiaochen and Liu, Hao and Ji, Jianguang and Sundquist, Kristina and Försti, Asta and Sundquist, Jan and Hemminki, Kari},
  issn         = {1569-8041},
  language     = {eng},
  pages        = {269--275},
  publisher    = {ARRAY(0x9754138)},
  series       = {Annals of Oncology},
  title        = {Subsequent cancers in patients diagnosed with cancer of unknown primary (CUP): etiological insights?},
  url          = {http://dx.doi.org/10.1093/annonc/mdr059},
  volume       = {23},
  year         = {2012},
}