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Second primary cancers related to smoking and treatment of small-cell lung cancer. Lung Cancer Working Cadre.
- Source :
- JNCI: Journal of the National Cancer Institute; 12/03/97, Vol. 89 Issue 23, p1782-1788, 7p, 1 Graph
- Publication Year :
- 1997
-
Abstract
- <bold>Background: </bold>An increased risk of second primary cancers has been reported in patients who survive small-cell carcinoma of the lung. The treatment's contribution to the development of second cancers is difficult to assess, in part because the number of long-term survivors seen at any one institution is small. We designed a multi-institution study to investigate the risk among survivors of developing second primary cancers other than small-cell lung carcinoma.<bold>Methods: </bold>Demographic, smoking, and treatment information were obtained from the medical records of 611 patients who had been cancer free for more than 2 years after therapy for histologically proven small-cell lung cancer, and person-years of follow-up were cumulated. Population-based rates of cancer incidence and mortality were used to estimate the expected number of cancers or deaths. The actuarial risk of second cancers was estimated by the Kaplan-Meier method.<bold>Results: </bold>Relative to the general population, the risk of all second cancers among these patients (mostly non-small-cell cancers of the lung) was increased 3.5-fold. Second lung cancer risk was increased 13-fold among those who received chest irradiation in comparison to a sevenfold increase among nonirradiated patients. It was higher in those who continued smoking, with evidence of an interaction between chest irradiation and continued smoking (relative risk = 21). Patients treated with various forms of combination chemotherapy had comparable increases in risk (9.4- to 13-fold, overall), except for a 19-fold risk increase among those treated with alkylating agents who continued smoking.<bold>Implications: </bold>Because of their substantially increased risk, survivors should stop smoking and may consider entering trials of secondary chemoprevention. [ABSTRACT FROM AUTHOR]
- Subjects :
- CANCER risk factors
CANCER treatment
SMALL cell lung cancer
SMOKING
HEALTH
Subjects
Details
- Language :
- English
- ISSN :
- 00278874
- Volume :
- 89
- Issue :
- 23
- Database :
- Complementary Index
- Journal :
- JNCI: Journal of the National Cancer Institute
- Publication Type :
- Academic Journal
- Accession number :
- 1722592