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. 2018 Nov;61(11):1250-1257.
doi: 10.1097/DCR.0000000000001203.

Secondary Breast, Ovarian, and Uterine Cancers After Colorectal Cancer: A Nationwide Population-Based Cohort Study in Korea

Dong Woo Shin  1 , Yoon Jin Choi  1 , Hyun Soo Kim  1 , Kyung-Do Han  2 , Hyuk Yoon  1 , Young Soo Park  1 , Nayoung Kim  1 , Dong Ho Lee  1   3
Affiliations

Secondary Breast, Ovarian, and Uterine Cancers After Colorectal Cancer: A Nationwide Population-Based Cohort Study in Korea

Dong Woo Shin et al. Dis Colon Rectum. 2018 Nov.

Abstract

Background: The risk of a second primary cancer has increased along with the increasing life expectancies of colorectal cancer survivors.

Objective: We aimed to evaluate the incidence rate and risk factors of breast and gynecological (ovarian, uterine cervix/corpus) cancers among female colorectal cancer survivors.

Design: This is a retrospective population-based cohort study.

Settings: This study used data from the National Health Insurance Corporation of Korea.

Patients: Each patient with colorectal cancer diagnosed from 2007 to 2012 was followed until 2015 and compared with age-matched women without colorectal cancer at a 1:5 ratio.

Main outcome measures: The primary outcome was de novo breast/gynecological cancer. Patients with available medical checkup data were included in an additional analysis.

Results: We analyzed 56,682 patients with colorectal cancer and 288,119 age-matched noncolorectal cancer controls. The risk of breast/gynecological cancer was higher among patients with colorectal cancer than among controls (HR, 2.91; p < 0.001). The association with colorectal cancer was the highest for ovarian cancer (HR, 6.72), followed by uterine corpus cancer (HR, 3.99), cervical cancer (HR, 2.82), and breast cancer (HR, 1.85). This association remained consistent in the subgroup analysis of medical checkup data (14,190 patients with colorectal cancer, 71,933 controls). Among patients with colorectal cancer, those aged <55 years had a higher risk of breast/gynecological cancers than those aged >55 years (HR, 3.51 vs 2.59), and those with dyslipidemia had a higher risk of breast cancer than those without dyslipidemia (HR, 2.66 vs 2.06).

Limitations: This was a retrospective, population-based study. A prospectively designed study is needed to validate our conclusions.

Conclusions: Compared with the general population, patients with colorectal cancer carry a higher risk of developing secondary breast, ovarian, and uterine cancers. See Video Abstract at http://links.lww.com/DCR/A731.

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Figures

FIGURE 1.
FIGURE 1.
CONSORT flow diagram of patient recruitment. CRC = colorectal cancer; NHIC = National Health Insurance Corporation.
FIGURE 2.
FIGURE 2.
Cumulative incidence of breast and gynecological cancers over time.
See this image and copyright information in PMC

References

    1. Rheingold SR, Neugut AI, Meadows AT.Bast RC, Jr, Kufe DW, Pollock RE, Weichselbaum RR, Holland JF, Frei E., 3rdSecondary cancers: incidence, risk factors, and management. In: Holland-Frei Cancer Medicine, 2003. 6th ed Hamilton (ON): BC Decker; Available at: https://www.ncbi.nlm.nih.gov/books/NBK12712/ Accessed September 15, 2017.
    1. Kufe DW, Pollock RE, Weichselbaum RR, Bast RC, Jr, Gansler TS.Cancer Medicine 6 Review: A Companion to Holland-Frei Cancer Medicine 6. 2003Hamilton (ON): BC Decker,
    1. Siegel RL, Miller KD, Jemal A.Cancer statistics, 2016. CA Cancer J Clin. 2016;66:7–30.. - PubMed
    1. Ferlay J, Soerjomataram I, Dikshit R, et al. Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer. 2015;136:E359–E386.. - PubMed
    1. Sankaranarayanan R, Ferlay J.Worldwide burden of gynaecological cancer: the size of the problem. Best Pract Res Clin Obstet Gynaecol. 2006;20:207–225.. - PubMed

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