Levi Fabio, Te Van-Cong, Randimbison Lalao, Maspoli Manuela, La Vecchia Carlo
Unité d'épidémiologie du cancer, Institut universitaire de médecine sociale et préventive, Lausanne, Switzerland.
Int J Cancer. 2006 Dec 1;119(11):2702-4. doi: 10.1002/ijc.22183.
Patients diagnosed with oral and pharyngeal (OP) cancer have a substantial excess risk of second OP cancer, but risk quantification is still uncertain and scanty information is available on the absolute excess risk of second OP cancer. We considered the risk of second OP primary cancer in a population-based series of 3,092 first primary OP cancers registered between 1974 and 2003 in the Swiss Cantons of Vaud and Neuchâtel (total population of about 786,000 inhabitants). A total of 233 second OP cancers were registered, versus 7.4 expected, corresponding to a SIR of 31.7 (95% confidence interval (CI) 27.7-36.0). The SIR was 68.5 in the first year after diagnosis of the first primary, and declined thereafter, leveling around 20. The SIR was 30.7 when the site of first neoplasm was the oral cavity, 42.5 for the tongue and 28.1 for the oropharynx or hypo-pharynx. Corresponding values for topographies of second primaries were 28.8, 50.4 and 26.2. The cumulative risk of second OP cancer 15 years after diagnosis of first OP cancer approached 22% in men and 17% in women. The incidence of first primaries increased over 20-fold between age 30-39 and 70-79, whereas there was no rise with age for second neoplasms.
被诊断患有口腔和咽癌（OP）的患者发生第二原发性OP癌的风险显著增加，但风险量化仍不确定，且关于第二原发性OP癌的绝对超额风险的信息很少。我们在瑞士沃州和纳沙泰尔州（总人口约78.6万居民）1974年至2003年登记的3092例第一原发性OP癌的基于人群的系列研究中，考虑了第二原发性OP癌的风险。共登记了233例第二原发性OP癌，而预期为7.4例，标准化发病比（SIR）为31.7（95%置信区间（CI）27.7 - 36.0）。在诊断第一原发性癌症后的第一年，SIR为68.5，此后下降，在20左右趋于平稳。当第一肿瘤部位为口腔时，SIR为30.7，舌部为42.5，口咽或下咽为28.1。第二原发性肿瘤相应的部位特异性值为28.8、50.4和26.2。在诊断第一原发性OP癌15年后，男性发生第二原发性OP癌的累积风险接近22%，女性为17%。第一原发性癌症的发病率在30 - 39岁至70 - 79岁之间增加了20多倍，而第二原发性肿瘤的发病率则没有随年龄增长而上升。
