The effect of patient characteristics on second primary cancer risk in France.

Jérémie Jégu (1, 2, 3, 4) , Marc Colonna (2, 5) , Laetitia Daubisse-Marliac (6, 2) , Brigitte Trétarre (2, 7) , Olivier Ganry (2, 8) , Anne-Valérie Guizard (9, 2) , Simona Bara (2, 10) , Xavier Troussard (11, 2) , Véronique Bouvier (9, 2) , Anne-Sophie Woronoff (12, 2) , Michel Velten (2, 4, 3)

1 Progression tumorale et microenvironnement. Approches translationnelles et épidémiologie
2 FRANCIM - Réseau des registres français du cancer
3 HUS - Les Hôpitaux Universitaires de Strasbourg
4 Registre des cancers du Bas-Rhin
5 Registre des cancers de l’Isère [CHU de Grenoble]
6 Institut Claudius Regaud
7 Registre des Tumeurs de l'Hérault
8 Registre général des cancers de la Somme
9 Cancers et préventions
10 CHPC - CH Centre Hospitalier Public du Cotentin
11 Registre des hémopathies malignes de Basse-Normandie [CHU Caen]
12 CEF2P / CARCINO - Carcinogénèse épithéliale : facteurs prédictifs et pronostiques - UFC (UR 3181)

BACKGROUND: Although cancer survivors are known to be at greater risk of developing second primary cancer (SPC), SPC incidence estimates in France are thus far lacking. We used a multivariate approach to compute these estimates and analyzed the effect of patient characteristics (gender, age at diagnosis, first cancer site, year of diagnosis and follow-up) on SPC risk. METHODS: Data from ten French population-based cancer registries were used to establish a cohort of all patients diagnosed with a first cancer between 1989 and 2004 and followed up until December 31, 2007. The person-year approach was used to estimate standardized incidence ratios (SIRs) and excess absolute risks (EARs) of metachronous SPC. Multivariate Poisson regression models were then used to model SIRs and EARs separately by gender, adjusting for age, year of diagnosis, follow-up and first cancer site. RESULTS: Among the 289,967 followed-up patients with a first primary cancer, 21,226 developed a SPC. The SIR was of 1.36 (95% CI, 1.35-1.38) and the EAR was of 39.4 excess cancers per 10,000 person-years (95% CI, 37.4-41.3). Among male and female patients, multivariate analyses showed that age, year of diagnosis, follow-up and first cancer site were often independently associated with SIRs and EARs. Moreover, the EAR of SPC remained elevated during patient follow-up. CONCLUSIONS: French cancer survivors face a dramatically increased risk of SPC which is probably related to the high rate of tobacco and alcohol consumption in France. Multivariate modeling of SPC risk will facilitate the construction of a tailored prediction tool to optimize SPC prevention and early detection strategies.

Mots clés: Neoplasms; Second primary; Risk assessment; Multivariate analysis; Registries; France

Domaines: Cancer

Jérémie Jégu, Marc Colonna, Laetitia Daubisse-Marliac, Brigitte Trétarre, Olivier Ganry, et al.. The effect of patient characteristics on second primary cancer risk in France.. BMC Cancer, 2014, 14 (1), pp.94. ⟨10.1186/1471-2407-14-94⟩. ⟨inserm-00948900⟩