Second primary cancers and survival in patients with gastric cancer: association with prediagnosis lifestyles
Menée au Portugal auprès de 574 patients atteints d'un cancer de l'estomac sur la période 2011-2017, cette étude analyse l'association entre des pratiques liées au mode de vie dans l'année précédant le diagnostic du premier cancer (tabagisme, consommation d'alcool, habitudes alimentaires), le risque de second cancer primitif et la survie (28 cas de second cancer primitif ; 409 décès)
To quantify the association between prediagnosis lifestyles with the risk of second primary cancers (SPCs) and survival of patients with gastric first primary cancer (FPC). We recruited 574 gastric patients from two major public hospitals in North Portugal (2001–2006). Smoking, alcohol and dietary habits in the year before FPC diagnosis were evaluated. Patients were followed up to 31 December 2011 for an SPC and to 31 May 2017 for vital status. Cox proportional hazards regression was used to estimate adjusted hazard ratios for incidence of an SPC or death. During follow-up, SPCs were diagnosed in five women and 23 men, and 409 patients died, corresponding to an estimated 10-year cumulative incidence of 5.2% for SPC and an estimated 15-year cumulative mortality of 72.1%. A significantly higher hazard ratio (95% confidence interval) for SPCs was observed in patients reporting a higher consumption of red and processed meat versus the lowest third (4.49: 1.31–15.37), and for mortality in those with heavy alcohol intake versus never drinkers (1.73: 1.00–2.99) and excess weight versus normal weight (1.31: 1.04–1.65); no other significant associations were observed according to prediagnosis lifestyle. Prediagnosis lifestyles may affect the occurrence of an SPC and survival among gastric FPC survivors in the long term. Correspondence to Nuno Lunet, MPH, PhD, Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina da Universidade do Porto, Al. Prof. Hernâni Monteiro, 4200-319 Porto, Portugal Tel: +351 225 513 652; fax: +351 225 513 653; e-mail: nlunet@med.up.pt Received September 21, 2017 Accepted January 22, 2018 Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.