Purpose: We conducted an exploratory study of brain tumors that occurr
ed as a second primary malignancy to identify potential risk factors f
or brain tumors.Methods: Using data from the Surveillance, Epidemiolog
y, and End Results (SEER) Program, we calculated the sex-specific stan
dardized incidence ratio (SIR), adjusted to age and rime period, as an
estimate of the relative risk (RR) of developing a second primary bra
in tumor following other cancers. Results: We found an elevated RR of
brain tumors after bladder cancer in both men (RR, 1.7; 95% confidence
interval [CI], 1.2 to 2.3) and women (RR, 1.7; 95% CI, 0.8 to 3.2); t
his effect was present for both astrocytoma and glioblastoma multiform
e. Elevated RRs of brain tumors were also found after sarcoma (RR, 4.4
; 95% CI, 1.8 to 9.0) and leukemia (RR, 2.9; 95% CI, 1.6 to 4.8) in me
n, and after colorectal cancer (RR, 1.8; 95% CI, 1.3 to 2.4) and endom
etrial cancer (RR, 1.4; 95% CI, 1.0 to 1.9) in women. The highest RR o
bserved in this study was for CNS lymphoma following any first primary
malignancy in men (RR, 7.9; 95% CI, 5.5 to 11.0). Conclusion: The ass
ociations of brain tumors with bladder, colorectal, and endometrial ca
ncers in women, and an increased occurrence of CNS lymphoma as a secon
d malignancy in men, are new findings that have not been described pre
viously. (C) 1995 by American Society of Clinical Oncology.