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Original Article
The association between histological subtype of a first primary endometrial cancer and second cancer risk
  1. Jennifer Rhoades1,
  2. Monica Hagan Vetter2,
  3. James L Fisher3,
  4. David E Cohn2,
  5. Ritu Salani2 and
  6. Ashley S Felix1
  1. 1 Division of Epidemiology, The Ohio State University College of Public Health, Columbus, Ohio, USA
  2. 2 Division of Gynecologic Oncology, The Ohio State University College of Medicine, Columbus, Ohio, USA
  3. 3 Arthur G James Cancer Hospital and Richard J. Solove Research Institute, Columbus, Ohio, USA
  1. Correspondence to Ashley S Felix, Division of Epidemiology, The Ohio State University College of Public Health, Columbus, OH 43210, USA; Felix.20{at}osu.edu

Abstract

Objective To evaluate the risk of a second primary cancer after endometrial cancer according to histological subtype.

Methods Using data from the 13 National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) registries we identified women diagnosed with a primary endometrial cancer between 1992 and 2014. We calculated standardized incidence ratios (SIRs) and 95% confidence intervals (CIs) for second primary cancer risk (all anatomical sites combined and for individual anatomical sites) among patients with endometrial cancer compared with the general population, in the overall study population and according to histological subtype.

Results Among 96 256 women diagnosed with endometrial cancer, 8.4% (n=8083) developed a second primary cancer. The risk of second primary cancer was higher among patients with endometrial cancer than in the general population (SIR=1.05, 95% CI 1.03 to 1.07). We observed significantly higher second primary cancer risk among women with high grade endometrioid (SIR=1.12, 95% CI 1.05 to 1.19), serous (SIR=1.24, 95% CI 1.11 to 1.38), carcinosarcoma (SIR=1.18, 95% CI 1.02 to 1.35), mixed epithelial (SIR=1.22, 95% CI 1.06 to 1.40), and sarcoma (SIR=1.28, 95% CI 1.12 to 1.45) compared with the general population, but not for women with low grade endometrioid (SIR=1.01, 95% CI 0.98 to 1.03) or clear cell (SIR=1.09, 95% CI 0.88 to 1.33) endometrial cancer. Women with low grade endometrioid endometrial cancer had significantly lower second primary cancer risks in the gum and other mouth (SIR=0.57, 95% CI 0.30 to 0.97), lung and bronchus (SIR=0.72, 95% CI 0.66 to 0.77), and lymphocytic leukemia (SIR=0.71, 95% CI 0.54 to 0.93) while women with high risk endometrial cancer histological subtypes experienced significantly higher second primary cancer risk at several anatomical sites.

Conclusions Risk of developing second primary cancersat all anatomic sites combined and at individual anatomical sites varied according to histological subtype. Clinicians should be aware that women with different histological subtypes carry different second primary cancer risks .

  • endometrial cancer
  • second primary cancer
  • histology
  • standardized incidence ratio
  • cancer registry

https://doi.org/10.1136/ijgc-2018-000014

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    Footnotes

    • Contributors JR: Data curation; formal analysis; writing the original draft; review and editing of the finaldraft. MHV: Writing the original draft; review and editing of the final draft. JLF: Writing the original draft; review and editing of the final draft. DEC: Writing the original draft;review and editing of the final draft. RS Writing the original draft;review and editing of the final draft. ASF: Conceptualization; supervision; data curation; formal analysis; methodology; writing the original draft; review and editing of the final draft.

    • Funding This work was supported by the National Cancer Institute (K01CA21845701A1 to ASF).

    • Competing interests None declared.

    • Patient consent Not required.

    • Ethics approval This study was considered exempt by the Institutional Review Board of the Ohio StateUniversity as all data are de-identified and intended for public use.

    • Provenance and peer review Not commissioned; externally peer reviewed.