Patients with Early-Onset Colorectal Cancer Have an Increased Risk of Second Primary Malignancy.
Colorectal cancer
Early onset
Second primary malignancy
Standardized incidence ratio
Journal
Digestive diseases and sciences
ISSN: 1573-2568
Titre abrégé: Dig Dis Sci
Pays: United States
ID NLM: 7902782
Informations de publication
Date de publication:
04 2022
04 2022
Historique:
received:
07
07
2020
accepted:
24
03
2021
pubmed:
8
4
2021
medline:
6
4
2022
entrez:
7
4
2021
Statut:
ppublish
Résumé
While overall colorectal cancer (CRC) rates in the USA are declining, the incidence of early-onset CRC (eoCRC) under age 50 is increasing. The aim of this study was to examine the risk of a second primary malignancy (SPM) in individuals with eoCRC, and how this risk compares to those with late-onset CRC (loCRC). We used data from the Surveillance, Epidemiology, and End Results Program database to examine the risk of SPM after a diagnosis of eoCRC. Standardized incidence ratios (SIR) were used to estimate the risk of SPM after eoCRC and loCRC in comparison with the risk of malignancy in the general population. Compared to the general population, individuals with eoCRC, but not loCRC, had an increased lifetime risk of SPM (SIR 1.42, 95% CI 1.37-1.48 and SIR 1.00, 95% CI 0.99-1.02, respectively), and locations at highest risk were the small intestine, ureter, rectum, and colon. The risk of SPM after eoCRC was similar in men and women, but higher in non-whites compared to whites and higher in those with a lower area-level median household income. The risk of SPM following eoCRC was high in the first 5 years after diagnosis (SIR 2.44, 95% CI 2.24-2.66) and, in a birth cohort analysis, was found to be increasing over time. Individuals with eoCRC have a lifetime risk of SPM nearly 50% higher than the general population. The risk of SPM is highest in the first 5 years after diagnosis and is increasing over time.
Sections du résumé
BACKGROUND
While overall colorectal cancer (CRC) rates in the USA are declining, the incidence of early-onset CRC (eoCRC) under age 50 is increasing. The aim of this study was to examine the risk of a second primary malignancy (SPM) in individuals with eoCRC, and how this risk compares to those with late-onset CRC (loCRC).
METHODS
We used data from the Surveillance, Epidemiology, and End Results Program database to examine the risk of SPM after a diagnosis of eoCRC. Standardized incidence ratios (SIR) were used to estimate the risk of SPM after eoCRC and loCRC in comparison with the risk of malignancy in the general population.
RESULTS
Compared to the general population, individuals with eoCRC, but not loCRC, had an increased lifetime risk of SPM (SIR 1.42, 95% CI 1.37-1.48 and SIR 1.00, 95% CI 0.99-1.02, respectively), and locations at highest risk were the small intestine, ureter, rectum, and colon. The risk of SPM after eoCRC was similar in men and women, but higher in non-whites compared to whites and higher in those with a lower area-level median household income. The risk of SPM following eoCRC was high in the first 5 years after diagnosis (SIR 2.44, 95% CI 2.24-2.66) and, in a birth cohort analysis, was found to be increasing over time.
CONCLUSIONS
Individuals with eoCRC have a lifetime risk of SPM nearly 50% higher than the general population. The risk of SPM is highest in the first 5 years after diagnosis and is increasing over time.
Identifiants
pubmed: 33826002
doi: 10.1007/s10620-021-06971-x
pii: 10.1007/s10620-021-06971-x
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1328-1336Informations de copyright
© 2021. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.
Références
Siegel RL, Jemal A, Ward EM. Increase in incidence of colorectal cancer among young men and women in the United States. Cancer Epidemiol Biomark Prev. 2009;18:1695–1698. https://doi.org/10.1158/1055-9965.Epi-09-0186 .
doi: 10.1158/1055-9965.Epi-09-0186
Siegel RL, Fedewa SA, Anderson WF et al. Colorectal cancer incidence patterns in the United States, 1974–2013. J Natl Cancer Inst. 2017;109:djw322. https://doi.org/10.1093/jnci/djw322 .
doi: 10.1093/jnci/djw322
pmcid: 6059239
Bailey CE, Hu C-Y, You YN et al. Increasing disparities in the age-related incidences of colon and rectal cancers in the United States, 1975–2010. JAMA Surg. 2015;150:17–22. https://doi.org/10.1001/jamasurg.2014.1756 .
doi: 10.1001/jamasurg.2014.1756
pubmed: 25372703
pmcid: 4666003
Surveillance, Epidemiology, and End Results (SEER) Program ( www.seer.cancer.gov ) SEER*Stat Database: Incidence—SEER Research Data, 9 Registrties, Nov 2019 Sub (1975–2017)—Linked to County Attributes—Time Dependent (1990–2017) Income/Rurality, 1969–2017 Counties, National Cancer Institute, DCCPS, Surveillance Research Program, released Apreil 2020, based on the November 2019 submission.
Surveillance Research Program. National Cancer Institute SEER*Stat software (seer.cancer.gov/seerstat) version 8.3.8.
Yang J, Li S, Lv M et al. Risk of subsequent primary malignancies among patients with prior colorectal cancer: a population-based cohort study. Onco Targets Ther. 2017;10:1535–1548. https://doi.org/10.2147/OTT.S129220 .
doi: 10.2147/OTT.S129220
pubmed: 28352187
pmcid: 5359119
Guan X, Jin Y, Chen Y et al. The incidence characteristics of second primary malignancy after diagnosis of primary colon and rectal cancer: a population based study. PLoS ONE. 2015;10:e0143067. https://doi.org/10.1371/journal.pone.0143067 .
doi: 10.1371/journal.pone.0143067
pubmed: 26571301
pmcid: 4646682
Hemminki K, Li X, Dong C. Second primary cancers after sporadic and familial colorectal cancer. Cancer Epidemiol Biomark Prev 2001;10:793–798.
Liang Y-H, Shao Y-Y, Chen H-M et al. Young patients with colorectal cancer have increased risk of second primary cancers. Jpn J Clin Oncol. 2015;45:1029–1035. https://doi.org/10.1093/jjco/hyv137 .
doi: 10.1093/jjco/hyv137
pubmed: 26386042
Donin N, Filson C, Drakaki A et al. Risk of second primary malignancies among cancer survivors in the United States, 1992 through 2008. Cancer. 2016;122:3075–3086. https://doi.org/10.1002/cncr.30164 .
doi: 10.1002/cncr.30164
pubmed: 27377470
He X, Wu W, Ye Ding, Li Y, Si J, Sun L. Excessive risk of second primary cancers in young-onset colorectal cancer survivors. Cancer Med. 2018;2018:1201–1210. https://doi.org/10.1002/cam4.1437 .
doi: 10.1002/cam4.1437
Boardman LA, Johnson RA, Petersen GM et al. Higher frequency of diploidy in young-onset microsatellite-stable colorectal cancer. Clin Cancer Res 2007;13:2323–2328. https://doi.org/10.1158/1078-0432.Ccr-06-2739 .
doi: 10.1158/1078-0432.Ccr-06-2739
pubmed: 17438090
Antelo M, Balaguer F, Shia J et al. A High Degree of LINE-1 hypomethylation is a unique feature of early-onset colorectal cancer. PLoS ONE. 2012;7:e45357. https://doi.org/10.1371/journal.pone.0045357 .
doi: 10.1371/journal.pone.0045357
pubmed: 23049789
pmcid: 3458035
Dwyer AJ, Murphy CC, Boland CR et al. A summary of the fight colorectal cancer working meeting: exploring risk factors and etiology of sporadic early-age onset colorectal cancer. Gastroenterology. 2019;157:280–288. https://doi.org/10.1053/j.gastro.2019.04.049 .
doi: 10.1053/j.gastro.2019.04.049
pubmed: 31095950
Ballester V, Rashtak S, Boardman L. Clinical and molecular features of young-onset colorectal cancer. World J Gastroenterol. 2016;22:1736–1744. https://doi.org/10.3748/wjg.v22.i5.1736 .
doi: 10.3748/wjg.v22.i5.1736
pubmed: 26855533
pmcid: 4724605
Hughes LAE, Melotte V, de Schrijver J et al. The CpG island methylator phenotype: what’s in a name? Cancer Research 2013;73:5858–5868. https://doi.org/10.1158/0008-5472.Can-12-4306 .
doi: 10.1158/0008-5472.Can-12-4306
pubmed: 23801749
You YN, Xing Y, Feig BW, Chang GJ, Cormier JN. Young-onset colorectal cancer: is it time to pay attention? JAMA Intern Med. 2012;172:287–289. https://doi.org/10.1001/archinternmed.2011.602 .
doi: 10.1001/archinternmed.2011.602
O’Connell JB, Maggard MA, Liu JH, Etzioni DA, Livingston EH, Ko CY. Do young colon cancer patients have worse outcomes? World Journal of Surgery. 2004;28:558–562. https://doi.org/10.1007/s00268-004-7306-7 .
doi: 10.1007/s00268-004-7306-7
pubmed: 15366745
Yeo H, Betel D, Abelson JS, Zheng XE, Yantiss R, Shah MA. Early-onset colorectal cancer is distinct from traditional colorectal cancer. Clin Colorectal Cancer. 2017;16:e6. https://doi.org/10.1016/j.clcc.2017.06.002 .
doi: 10.1016/j.clcc.2017.06.002
Gervaz P, Bucher P, Neyroud-Caspar I, Soravia C, Morel P. Proximal location of colon cancer is a risk factor for development of metachronous colorectal cancer: a population-based study. Dis Colon Rectum. 2005;48:227–232. https://doi.org/10.1007/s10350-004-0805-7 .
doi: 10.1007/s10350-004-0805-7
pubmed: 15711864
Pearlman R, Frankel WL, Swanson B et al. Prevalence and spectrum of germline cancer susceptibility gene mutations among patients with early-onset colorectal cancer. JAMA Oncol. 2017;3:464–471. https://doi.org/10.1001/jamaoncol.2016.5194 .
doi: 10.1001/jamaoncol.2016.5194
pubmed: 27978560
pmcid: 5564179
De Pergola G, Silvestris F. Obesity as a major risk factor for cancer. J Obes 2013;2013:291546. https://doi.org/10.1155/2013/291546 .
doi: 10.1155/2013/291546
pubmed: 24073332
pmcid: 3773450
Botteri E, Iodice S, Bagnardi V, Raimondi S, Lowenfels AB, Maisonneuve P. Smoking and colorectal cancer: a meta-analysis. JAMA. 2008;300:2765–2778. https://doi.org/10.1001/jama.2008.839 .
doi: 10.1001/jama.2008.839
pubmed: 19088354
Nelson DE, Mowery P, Asman K et al. Long-term trends in adolescent and young adult smoking in the United States: metapatterns and implications. Am J Public Health. 2008;98:905–915. https://doi.org/10.2105/ajph.2007.115931 .
doi: 10.2105/ajph.2007.115931
pubmed: 18382001
pmcid: 2374818
Pierce JP, Fiore MC, Novotny TE, Hatziandreu EJ, Davis RM. Trends in cigarette smoking in the United States: educational differences are increasing. JAMA. 1989;261:56–60. https://doi.org/10.1001/jama.1989.03420010066034 .
doi: 10.1001/jama.1989.03420010066034
pubmed: 2908995
Ng J, Shuryak I. Minimizing second cancer risk following radiotherapy: current perspectives. Cancer Manag Res. 2014;7:1–11.
doi: 10.2147/CMAR.S47220