Japanese Journal of Clinical Oncology, Vol 29, Issue 2 96-105, Copyright © 1999 by Foundation for Promotion of Cancer Research
S Kaneko and N Yamaguchi
BACKGROUND: Multiple primary cancer (MPC) has been recognized as a problem
commonly encountered in routine medical practice. A study of MPC is
necessary not only to provide insights into the etiology of cancer, but
also to provide information for effective medical care by clinical
oncologists. METHODS: A cohort of 49,751 cancer patients who were admitted
to the National Cancer Center Hospital between 1962 and 1996 was used to
study the site relationship of MPC. Logistic and Poisson regression
analyses using an internal reference group within the cohort were applied
for the calculation of the prevalence odds ratio (POR) for site
relationships of synchronous MPC and the incidence rate ratio (IRR) for
those of metachronous MPC. RESULTS: Three site combinations with elevated
risks for both synchronous and metachronous MPCs, eight with elevated risk
for synchronous MPC, five with elevated risk for metachronous MPC and six
with decreased risk for synchronous MPC were identified with statistical
significance. Among them, the increased risk of metachronous stomach cancer
following lymphoma and myeoloma (POR = 1.0 and 1.1, P > 0.05; IRR = 2.5,
P < 0.05) and the inverse site-correlation of synchronous MPC between
[trachea, bronchus and lung] and other sites of the upper aerodigestive
tract [lip, oral cavity and pharynx] (POR = 0.5 and 0.3, P < 0.05) and
esophagus (POR = 0.7 and 0.3, P < 0.05) have not been reported
previously. CONCLUSIONS: Our results suggest that interventions for
lymphoma and myeloma might affect the development of subsequent stomach
cancer and additional etiological factors other than tobacco smoking are
associated with the development of cancer in the upper aerodigestive tract.
ORIGINAL ARTICLE
Epidemiological analysis of site relationships of synchronous and metachronous multiple primary cancers in the National Cancer Center, Japan, 1962-1996
Cancer Information and Epidemiology Division, National Cancer Center Research Institute, Tokyo, Japan.
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