Second Cancers Among 40 576 Testicular Cancer Patients: Focus on Long-term Survivors

作者：Lois B. Travis, Sophie D. Fosså, Sara J. Schonfeld, Mary L. McMaster, Charles F. Lynch, Hans Henrik Storm, Per N Hall, Eric J. Holowaty, Aage Andersen, ­Eero Pukkala, Michael Andersson, Magnus Kaijser, Mary Krystyna Gospodarowicz, Timo K. Joensuu, R.J. Cohen, John D. Boice, Graça M. Dores, Ethel S. Gilbert · 发表于：JNCI Journal of the National Cancer Institute · 年份：2005 · DOI：10.1093/jnci/dji278 · 被引用次数：832 · 研究领域：Multiple and Secondary Primary Cancers、Testicular diseases and treatments、Genetic factors in colorectal cancer

BACKGROUND: Although second primary cancers are a leading cause of death among men with testicular cancer, few studies have quantified risks among long-term survivors. METHODS: Within 14 population-based tumor registries in Europe and North America (1943-2001), we identified 40,576 1-year survivors of testicular cancer and ascertained data on any new incident solid tumors among these patients. We used Poisson regression analysis to model relative risks (RRs) and excess absolute risks (EARs) of second solid cancers. All statistical tests were two-sided. RESULTS: A total of 2,285 second solid cancers were reported in the cohort. The relative risk and EAR decreased with increasing age at testicular cancer diagnosis (P < .001); the EAR increased with attained age (P < .001) but the excess RR decreased. Among 10-year survivors diagnosed with testicular cancer at age 35 years, the risk of developing a second solid tumor was increased (RR = 1.9, 95% confidence interval [CI] = 1.8 to 2.1). Risk remained statistically significantly elevated for 35 years (RR = 1.7, 95% CI = 1.5 to 2.0; P < .001). We observed statistically significantly elevated risks, for the first time, for cancers of the pleura (malignant mesothelioma; RR = 3.4, 95% CI = 1.7 to 5.9) and esophagus (RR = 1.7, 95% CI = 1.0 to 2.6). Cancers of the lung (RR = 1.5, 95% CI = 1.2 to 1.7), colon (RR = 2.0, 95% CI = 1.7 to 2.5), bladder (RR = 2.7, 95% CI = 2.2 to 3.1), pancreas (RR = 3.6, 95% CI = 2.8 to 4.6), and stomach (RR ...