2ND PRIMARY CANCERS AFTER VULVAR AND VAGINAL CANCERS

OBJECTIVE: Our objective was to examine the occurrence of second prima ry cancers after vaginal and vulvar cancers. STUDY DESIGN: Women in wh om cancers of the vagina (in situ, n = 461; invasive, n = 888) and vul va (in situ, n = 2898; invasive, n = 2685) were diagnosed between 1973 and 1988 were identified from nine population-based cancer registries . Subjects were followed through 1989 for the development of a subsequ ent primary cancer. RESULTS: We found increased risks of all second ca ncers combined among women with cancer of the vulva (observed/expected in situ = 1.5; observed/expected invasive = 1.3) and vagina (observed /expected invasive = 1.2). Most of the excess second cancers were smok ing related (e.g., cancers of the lung, buccal cavity and pharynx, eso phagus, nasal cavity and larynx) or related to infection with human pa pillomavirus (e.g., cervix, vulva, vagina, and anus). CONCLUSION: Thes e associations indicate that the follow-up care of women with cancers of the vulva and vagina should involve efforts to promote smoking cess ation. The data are also consistent with a common sexually related cau se for cancers of the cervix, vulva, vagina, and anus.