Originally published as JCO Early Release 10.1200/JCO.2008.18.4549 on December 29 2008

This Article Full Text Full Text (PDF) Purchase Article View Shopping Cart Alert me when this article is cited Alert me if a correction is posted Services Email this article to a colleague Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Save to my personal folders Download to citation manager Rights & Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Chaturvedi, A. K. Articles by Engels, E. A. Search for Related Content PubMed PubMed Citation Articles by Chaturvedi, A. K. Articles by Engels, E. A. Social Bookmarking                            What's this?

Second Cancers After Squamous Cell Carcinoma and Adenocarcinoma of the Cervix

From the Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, MD; The University of Iowa, Iowa City, IA; Danish Cancer Society, Copenhagen, Denmark; Karolinska Institutet, Stockholm, Sweden; Cancer Registry of Norway, Oslo, Norway; Finnish Cancer Registry; and the Helsinki University Central Hospital, Helsinki, Finland.

Corresponding author: Anil K. Chaturvedi, PhD, Infections and Immunoepidemiology Branch, Division of Cancer Epidemiology and Genetics, 6120 Executive Blvd, EPS 7072, Rockville, MD 20852; e-mail: chaturva{at}mail.nih.gov.

Purpose Although cervical squamous cell carcinoma (SCC) and adenocarcinoma (AC) are both caused by human papillomavirus (HPV) infection, they differ in cofactors such as cigarette smoking. We assessed whether these cofactor differences translate into differences in second cancer risk.

Patients and Methods We assessed second cancer risk among 85,109 cervical SCC and 10,280 AC survivors reported to population-based cancer registries in Denmark, Finland, Norway, Sweden, and the United States. Risks compared to the general population were assessed using standardized incidence ratios (SIR).

Results Overall cancer risk was significantly increased among both cervical SCC survivors (n = 10,559 second cancers; SIR, 1.31; 95% CI, 1.29 to 1.34) and AC survivors (n = 920 second cancers; SIR, 1.29; 95% CI, 1.22 to 1.38). Risks of HPV-related and radiation-related cancers were increased to a similar extent among cervical SCC and AC survivors. Although significantly increased in both groups when compared with the general population, risk of smoking-related cancers was significantly higher among cervical SCC than AC survivors (P = .015; SIR for cervical SCC = 2.07 v AC = 1.78). This difference was limited to lung cancer (SIR for cervical SCC = 2.69 v AC = 2.18; P = .026). The increased lung cancer risk among cervical AC survivors was observed for both lung SCC and lung AC. SIRs for second cancers of the colon, soft tissue, melanoma, and non-Hodgkin's lymphoma were significantly higher among cervical AC than SCC survivors.

Conclusion The second cancer profiles among cervical SCC and AC survivors mirror the similarities and differences in cofactors for these two histologies. Because smoking is not a cofactor for cervical AC, the increased lung cancer risk suggests a role for additional factors.

Supported by the Intramural Research Program, National Cancer Institute, National Institutes of Health.

Authors' disclosures of potential conflicts of interest and author contributions are found at the end of this article.

CiteULike    Complore    Connotea    Del.icio.us    Digg    Facebook    Reddit    Technorati    Twitter    What's this?

This article has been cited by other articles:

				M. Srinivasan, E. Taioli, and C. C.Ragin Human papillomavirus type 16 and 18 in primary lung cancers--a meta-analysis Carcinogenesis, October 1, 2009; 30(10): 1722 - 1728. [Abstract] [Full Text] [PDF]

				A. K. Chaturvedi, R. A. Kleinerman, A. Hildesheim, E. S. Gilbert, H. Storm, C. F. Lynch, P. Hall, F. Langmark, E. Pukkala, M. Kaijser, et al. Reply to P.A. Leppaluoto J. Clin. Oncol., June 20, 2009; 27(18): 3066 - 3067. [Full Text] [PDF]

				P. A. Leppaluoto Nonsmoking: A Surrogate Factor in Primary Lung Cancer in Survivors of Cervical Adenocarcinoma? J. Clin. Oncol., June 20, 2009; 27(18): 3065 - 3066. [Full Text] [PDF]