H. Tsukuma et al., INCIDENCE OF 2ND PRIMARY CANCERS IN OSAKA RESIDENTS, JAPAN, WITH SPECIAL REFERENCE TO CUMULATIVE AND RELATIVE RISKS, Japanese journal of cancer research, 85(4), 1994, pp. 339-345
This study was conducted to examine the incidence rates and cumulative
risks of second primary cancers in Osaka and to compare the observed
number of second primary cancers with the expected number calculated u
sing cancer incidence rates among Osaka residents. Study subjects were
all reported cases aged 0-79 who were first diagnosed as having a fir
st primary cancer between 1966-86. Incidence of second primary cancer
among the study subjects was examined through to the end of 1989. The
total number of study subjects was 217,307. During the follow-up perio
d (mean duration: 3.7 years), second primary cancers developed in 5,07
1 patients (2.3%). Incidence of synchronous (interval <3 months) and m
etachronous (interval greater than or equal to 3 months) second primar
y cancers increased in the later years. Incidence rates of second prim
ary cancers were significantly associated with gender (male), age and
calendar year at diagnosis of the first cancer. Based on the incidence
rates, cumulative risk of developing metachronous second primary canc
er was calculated. The ten-year cumulative risk was estimated as 10% f
or those who developed their first cancer during their sixties in 1978
-83. The observed number of second primary cancers (including synchron
ous) was compared with the expected number. The ratios of observed-to-
expected numbers were generally lower than 1.0 among those who develop
ed their first cancer in 1966-77, while these ratios were higher than
1.0 among those who developed their first cancer in 1978-86. The ratio
s were much higher than 1.0 among those who developed their first canc
er in their childhood and youth. Patients who had developed cancer of
the colon, larynx, lung, bladder, or breast (female) showed significan
tly higher risk of developing second primary cancer during the period
1-4 years after diagnosis of the first cancer.