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Risk of Second Malignant Neoplasms Among Long-term Survivors of Testicular Cancer
- Source :
- Journal of the National Cancer Institute, 89, 1429-1439. Oxford University Press
- Publication Year :
- 1997
- Publisher :
- Oxford University Press (OUP), 1997.
-
Abstract
- Background We have quantified the site-specific risk of second malignant neoplasms among nearly 29,000 survivors (> or = 1 year) of testicular cancer, taking into account the histologic type of initial cancer and the primary therapy used to treat it. Methods The study cohort consisted of 28,843 men identified within 16 population-based tumor registries in North America and Europe; over 3300 men had survived more than 20 years. New invasive cancers were identified through a search of registry files. Results Second cancers were reported in 1406 men (observed-to-expected ratio [O/E] = 1.43; 95% confidence interval = 1.36-1.51), with statistically significant excesses noted for acute lymphoblastic leukemia (O/E = 5.20), acute nonlymphocytic leukemia (O/E = 3.07), melanoma (O/E = 1.69), non-Hodgkin's lymphoma (O/E = 1.88), and cancers of the stomach (O/E = 1.95), colon (O/E = 1.27), rectum (O/E = 1.41), pancreas (O/E = 2.21), prostate (O/E = 1.26), kidney (O/E = 1.50), bladder (O/E = 2.02), thyroid (O/E = 2.92), and connective tissue (O/E = 3.16). Overall risk was similar after seminomas (O/E = 1.42) or nonseminomatous tumors (O/E = 1.50). Risk of solid tumors increased with time since the diagnosis of testicular cancer, yielding an O/E = 1.54 (O = 369) among 20-year survivors (two-sided P for trend = .00002). Secondary leukemia was associated with both radiotherapy and chemotherapy, whereas excess cancers of the stomach, bladder, and, possibly, pancreas were associated mainly with radiotherapy. Conclusions Men with testicular cancer continue to be at significantly elevated risk of second malignant neoplasms for more than two decades following initial diagnosis. Patterns of excess second cancers suggest that many factors may be involved, although the precise roles of treatment, natural history, diagnostic surveillance, and other influences are yet to be clarified.
- Subjects :
- Male
Cancer Research
medicine.medical_specialty
Pathology
medicine.medical_treatment
Population
Antineoplastic Agents
Gastroenterology
SDG 3 - Good Health and Well-being
Testicular Neoplasms
Risk Factors
Stomach Neoplasms
Internal medicine
Confidence Intervals
medicine
Humans
Registries
Risk factor
education
Melanoma
Survival rate
Testicular cancer
Neoplasms, Connective Tissue
education.field_of_study
Radiotherapy
Rectal Neoplasms
business.industry
Lymphoma, Non-Hodgkin
Prostatic Neoplasms
Cancer
Neoplasms, Second Primary
Seminoma
Precursor Cell Lymphoblastic Leukemia-Lymphoma
medicine.disease
Kidney Neoplasms
United States
Pancreatic Neoplasms
Survival Rate
Radiation therapy
Leukemia, Myeloid, Acute
Leukemia
Urinary Bladder Neoplasms
Oncology
Colonic Neoplasms
business
SEER Program
Subjects
Details
- ISSN :
- 14602105 and 00278874
- Volume :
- 89
- Database :
- OpenAIRE
- Journal :
- JNCI Journal of the National Cancer Institute
- Accession number :
- edsair.doi.dedup.....cac9a67fb4a65a032aebb2473c9927e4