Second primary cancers after liver, gallbladder and bile duct cancers, and these cancers as second primary cancers
(2021) In Clinical Epidemiology 13. p.683-691- Abstract
Background: Second primary cancers (SPCs) are important clinically as they may negatively influence patient survival and they may tell about therapeutic side effects and general causes of cancer. Population-based literature concerning SPCs after hepatobiliary cancers is limited and here we assess risks of SPCs after hepatocellular cancer (HCC), and cancers of the gallbladder, bile ducts and ampulla of Vater. In reverse order, we consider the risk of hepatobiliary cancers as SPCs after any cancer. Methods: We used standardized incidence ratios (SIRs) to estimate bidirectional relative risks of subsequent cancers associated with hepatobiliary cancers. Cancer diagnoses were obtained from the Swedish Cancer Registry from years 1990 through... (More)
Background: Second primary cancers (SPCs) are important clinically as they may negatively influence patient survival and they may tell about therapeutic side effects and general causes of cancer. Population-based literature concerning SPCs after hepatobiliary cancers is limited and here we assess risks of SPCs after hepatocellular cancer (HCC), and cancers of the gallbladder, bile ducts and ampulla of Vater. In reverse order, we consider the risk of hepatobiliary cancers as SPCs after any cancer. Methods: We used standardized incidence ratios (SIRs) to estimate bidirectional relative risks of subsequent cancers associated with hepatobiliary cancers. Cancer diagnoses were obtained from the Swedish Cancer Registry from years 1990 through 2015. Results: We identified 9997 primary HCCs, 1365 gallbladder cancers and 4721 bile duct cancers. After HCC, risks of four SPCs were increased: gallbladder (SIR = 4.38; 95% confidence interval 1.87–8.67), thyroid (4.13; 1.30–9.70), kidney (2.92; 1.66–4.47) and squamous cell skin (1.55; 1.02–2.26) cancers. In reverse order, HCC as SPC, in addition to the above cancers, associations included upper aerodigestive tract, esophageal, small intestinal and bladder cancers and non-Hodgkin lymphoma. For gallbladder and bile duct cancers, associations were found with small intestinal and pancreatic cancers. Conclusion: The results suggested that HCC is associated with two types of SPC, one related to shared environmental risk factors, such as alcohol, exemplified by upper aero-digestive tract and esophageal cancer, and the other related to immune dysfunction, exemplified by squamous cell skin cancer. SPCs associated with gallbladder and bile duct cancers suggest predisposition to mutations in the mismatch repair gene MLH1.
(Less)
- author
- Zheng, Guoqiao LU ; Sundquist, Kristina LU ; Sundquist, Jan LU ; Chen, Tianhui LU ; Försti, Asta LU ; Hemminki, Akseli ; Liska, Vaclav and Hemminki, Kari LU
- organization
- publishing date
- 2021
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Cancer etiology, Cancer incidence, Hepatobiliary cancer, Relative risk, Second primary cancer
- in
- Clinical Epidemiology
- volume
- 13
- pages
- 9 pages
- publisher
- Dove Medical Press Ltd.
- external identifiers
-
- pmid:34377034
- scopus:85112182350
- ISSN
- 1179-1349
- DOI
- 10.2147/CLEP.S318737
- language
- English
- LU publication?
- yes
- id
- 02801fbf-9924-4d6f-a264-a34ff59febe4
- date added to LUP
- 2021-09-13 10:55:28
- date last changed
- 2024-06-15 16:11:44
@article{02801fbf-9924-4d6f-a264-a34ff59febe4,
abstract = {{<p>Background: Second primary cancers (SPCs) are important clinically as they may negatively influence patient survival and they may tell about therapeutic side effects and general causes of cancer. Population-based literature concerning SPCs after hepatobiliary cancers is limited and here we assess risks of SPCs after hepatocellular cancer (HCC), and cancers of the gallbladder, bile ducts and ampulla of Vater. In reverse order, we consider the risk of hepatobiliary cancers as SPCs after any cancer. Methods: We used standardized incidence ratios (SIRs) to estimate bidirectional relative risks of subsequent cancers associated with hepatobiliary cancers. Cancer diagnoses were obtained from the Swedish Cancer Registry from years 1990 through 2015. Results: We identified 9997 primary HCCs, 1365 gallbladder cancers and 4721 bile duct cancers. After HCC, risks of four SPCs were increased: gallbladder (SIR = 4.38; 95% confidence interval 1.87–8.67), thyroid (4.13; 1.30–9.70), kidney (2.92; 1.66–4.47) and squamous cell skin (1.55; 1.02–2.26) cancers. In reverse order, HCC as SPC, in addition to the above cancers, associations included upper aerodigestive tract, esophageal, small intestinal and bladder cancers and non-Hodgkin lymphoma. For gallbladder and bile duct cancers, associations were found with small intestinal and pancreatic cancers. Conclusion: The results suggested that HCC is associated with two types of SPC, one related to shared environmental risk factors, such as alcohol, exemplified by upper aero-digestive tract and esophageal cancer, and the other related to immune dysfunction, exemplified by squamous cell skin cancer. SPCs associated with gallbladder and bile duct cancers suggest predisposition to mutations in the mismatch repair gene MLH1.</p>}},
author = {{Zheng, Guoqiao and Sundquist, Kristina and Sundquist, Jan and Chen, Tianhui and Försti, Asta and Hemminki, Akseli and Liska, Vaclav and Hemminki, Kari}},
issn = {{1179-1349}},
keywords = {{Cancer etiology; Cancer incidence; Hepatobiliary cancer; Relative risk; Second primary cancer}},
language = {{eng}},
pages = {{683--691}},
publisher = {{Dove Medical Press Ltd.}},
series = {{Clinical Epidemiology}},
title = {{Second primary cancers after liver, gallbladder and bile duct cancers, and these cancers as second primary cancers}},
url = {{http://dx.doi.org/10.2147/CLEP.S318737}},
doi = {{10.2147/CLEP.S318737}},
volume = {{13}},
year = {{2021}},
}