Incidence of smoking-related second primary cancers after lung cancer in Germany: an analysis of nationwide cancer registry data
Menée en Allemagne à l'aide de données 2002-2013 de registres des cancers portant sur 135 589 personnes ayant survécu à un cancer du poumon (68,2 % d'hommes ; durée moyenne de suivi : 30,8 mois), cette étude analyse le risque de développer un second cancer lié au tabagisme (5 298 cas de cancer), en fonction du sexe et par localisation
Introduction: About 80% of lung cancer cases in Germany are attributable to smoking. Patients with a lung cancer diagnosis may remain at increased risk of developing smoking-related second primary cancers (SPC). Methods: Anonymous data from 11 population-based cancer registries covering about 50% of the German population were pooled for the analysis. Included patients were diagnosed with an index lung cancer between 2002 and 2013, 30 to 99 years old at diagnosis and survived for at least 6 months. We calculated standardized incidence ratios (SIR) – stratified by age, sex, region and period – comparing the incidence of smoking-related and other SPC to the general population. Results: Of the 135,589 lung cancer survivors (68.2% male; mean follow-up 30.8 months) analyzed, 5,298 developed an SPC. In males the risk was particularly high for SPCs of the larynx (SIR = 3.70; 95% CI: 3.14–4.34), pharynx (3.17; 2.61–3.81) and oral cavity (2.86; 2.38–3.41). For females SIRs were notably elevated for esophagus (4.66; 3.15–6.66), oral cavity (3.14; 2.03–4.63) and urinary tract (2.68; 2.04–3.45). When combining all smoking-related cancer sites, SIR was 1.41 in males (95% CI: 1.36–1.47) and 1.81 in females (95% CI: 1.68–1.94). We observed that males had a 1.46-fold (95% CI: 1.37–1.56) and females a 1.33-fold (95% CI: 1.20–1.47) increased risk for smoking-related compared to other cancers. Conclusions: Patients with primary lung cancer were at increased risk for developing a smoking-related SPC. Therefore, the advantages of increased patient surveillance and the benefits of smoking cessation strategies should be considered.