Risk of Colorectal Cancer Among Long-term Cervical Cancer Survivors

Overview

Journal Med Oncol

Publisher Springer

Specialty Oncology

Date 2014 Apr 4

PMID 24696219

Citations 13

Authors

Ana M Rodriguez

Yong-Fang Kuo

James S Goodwin

Affiliations

Soon will be listed here.

Abstract

Because advances in therapy have increased long-term survival for women with cervical cancer, it is important to study the risk of secondary primary malignancies in high-dose organ areas. From the 1973-2009 National Cancer Institute Surveillance, Epidemiology, and End Results (SEER) program, we studied the risk of developing cancer of the colon and rectum in 64,507 cervical cancer patients over 35 years after initial radiation treatment. We also assessed change in risk over time. Kaplan-Meier estimator for survival curve and Cox proportional hazards models was used. More than half (52.6%) of the cervical cancer patients received radiation treatment. In the analyses adjusted for race/ethnicity, age, marital status, surgery status, stage and grade, the risk of colon cancer between those both with and without XRT diverged beginning at approximately 8 years. After 8 years, the hazard ratio for developing colon cancer was 2.00 (95% CI 1.43-2.80) for women with radiation versus those without radiation treatment. The risk of rectal cancer diverged after 15 years of follow-up (HR 4.04, 95% CI 2.08-7.86). After 35 years of follow-up, the absolute risk of developing colon cancer was 6.5% for those who received radiation versus 2.5% for those without, and 3.7 versus 0.8% for rectum. The risk of colon and rectum cancer over 20 years of follow-up after radiation remained the same across three eras (1973-1980, 1981-1990, and 1991-2000). Radiation-induced second cancers of the colon and rectum may occur 8 years after radiation treatment for cervical cancer.

Citing Articles

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Survival outcomes in prostate cancer patients with a prior cancer.

Zang Y, Qi F, Cheng Y, Xia T, Xiao R, Li X Transl Androl Urol. 2021; 10(2):741-753.

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NCCN Guidelines Insights: Survivorship, Version 2.2020.

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Leiomyosarcoma of the Rectum as a Radiation-Induced Second Malignancy after Cervical Cancer Treatment: Case Report with Review of the Literature.

Makhmudov D, Kolesnik O, Lagoda N, Volk M Case Rep Oncol Med. 2019; 2019:1610653.

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References

Berrington de Gonzalez A, Curtis R, Kry S, Gilbert E, Lamart S, Berg C . Proportion of second cancers attributable to radiotherapy treatment in adults: a cohort study in the US SEER cancer registries. Lancet Oncol. 2011; 12(4):353-60. PMC: 3086738. DOI: 10.1016/S1470-2045(11)70061-4. View

Maher E, Denton A . Survivorship, late effects and cancer of the cervix. Clin Oncol (R Coll Radiol). 2008; 20(6):479-87. DOI: 10.1016/j.clon.2008.04.009. View

Jemal A, Simard E, Dorell C, Noone A, Markowitz L, Kohler B . Annual Report to the Nation on the Status of Cancer, 1975-2009, featuring the burden and trends in human papillomavirus(HPV)-associated cancers and HPV vaccination coverage levels. J Natl Cancer Inst. 2013; 105(3):175-201. PMC: 3565628. DOI: 10.1093/jnci/djs491. View

Michnovicz J, Hershcopf R, Naganuma H, Bradlow H, Fishman J . Increased 2-hydroxylation of estradiol as a possible mechanism for the anti-estrogenic effect of cigarette smoking. N Engl J Med. 1986; 315(21):1305-9. DOI: 10.1056/NEJM198611203152101. View

Williams R, Horm J . Association of cancer sites with tobacco and alcohol consumption and socioeconomic status of patients: interview study from the Third National Cancer Survey. J Natl Cancer Inst. 1977; 58(3):525-47. DOI: 10.1093/jnci/58.3.525. View

Terry P, Rohan T, Franceschi S, Weiderpass E . Cigarette smoking and the risk of endometrial cancer. Lancet Oncol. 2002; 3(8):470-80. DOI: 10.1016/s1470-2045(02)00816-1. View

Oeffinger K, Baxi S, Friedman D, Moskowitz C . Solid tumor second primary neoplasms: who is at risk, what can we do?. Semin Oncol. 2013; 40(6):676-89. PMC: 3921623. DOI: 10.1053/j.seminoncol.2013.09.012. View

Stovall M, Smith S, Rosenstein M . Tissue doses from radiotherapy of cancer of the uterine cervix. Med Phys. 1989; 16(5):726-33. DOI: 10.1118/1.596331. View

Chaturvedi A, Engels E, Gilbert E, Chen B, Storm H, Lynch C . Second cancers among 104,760 survivors of cervical cancer: evaluation of long-term risk. J Natl Cancer Inst. 2007; 99(21):1634-43. DOI: 10.1093/jnci/djm201. View

10.

Hoffmeister M, Jansen L, Stock C, Chang-Claude J, Brenner H . Smoking, lower gastrointestinal endoscopy, and risk for colorectal cancer. Cancer Epidemiol Biomarkers Prev. 2014; 23(3):525-33. DOI: 10.1158/1055-9965.EPI-13-0729-T. View

11.

Hoffmeister M, Schmitz S, Karmrodt E, Stegmaier C, Haug U, Arndt V . Male sex and smoking have a larger impact on the prevalence of colorectal neoplasia than family history of colorectal cancer. Clin Gastroenterol Hepatol. 2010; 8(10):870-6. DOI: 10.1016/j.cgh.2010.07.004. View

12.

Giordano S, Kuo Y, Freeman J, Buchholz T, Hortobagyi G, Goodwin J . Risk of cardiac death after adjuvant radiotherapy for breast cancer. J Natl Cancer Inst. 2005; 97(6):419-24. PMC: 1853253. DOI: 10.1093/jnci/dji067. View

13.

de Moor J, Mariotto A, Parry C, Alfano C, Padgett L, Kent E . Cancer survivors in the United States: prevalence across the survivorship trajectory and implications for care. Cancer Epidemiol Biomarkers Prev. 2013; 22(4):561-70. PMC: 3654837. DOI: 10.1158/1055-9965.EPI-12-1356. View

14.

Boice Jr J, Engholm G, Kleinerman R, Blettner M, Stovall M, LISCO H . Radiation dose and second cancer risk in patients treated for cancer of the cervix. Radiat Res. 1988; 116(1):3-55. View

15.

Tubiana M . Can we reduce the incidence of second primary malignancies occurring after radiotherapy? A critical review. Radiother Oncol. 2009; 91(1):4-15. DOI: 10.1016/j.radonc.2008.12.016. View

16.

Brenner D, Curtis R, Hall E, Ron E . Second malignancies in prostate carcinoma patients after radiotherapy compared with surgery. Cancer. 2000; 88(2):398-406. DOI: 10.1002/(sici)1097-0142(20000115)88:2<398::aid-cncr22>3.0.co;2-v. View

17.

Kleinerman R, Boice Jr J, Storm H, Sparen P, Andersen A, Pukkala E . Second primary cancer after treatment for cervical cancer. An international cancer registries study. Cancer. 1995; 76(3):442-52. DOI: 10.1002/1097-0142(19950801)76:3<442::aid-cncr2820760315>3.0.co;2-l. View

18.

Elena J, Travis L, Simonds N, Ambrosone C, Ballard-Barbash R, Bhatia S . Leveraging epidemiology and clinical studies of cancer outcomes: recommendations and opportunities for translational research. J Natl Cancer Inst. 2012; 105(2):85-94. PMC: 3545903. DOI: 10.1093/jnci/djs473. View

19.

MARCIAL V, Marcial L . Radiation therapy of cervical cancer. New developments. Cancer. 1993; 71(4 Suppl):1438-45. View

20.

Zhou B, Yang L, Sun Q, Cong R, Gu H, Tang N . Cigarette smoking and the risk of endometrial cancer: a meta-analysis. Am J Med. 2008; 121(6):501-508.e3. DOI: 10.1016/j.amjmed.2008.01.044. View