Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Coordinating Center for Health Promotion, Centers for Disease Control and Prevention, 4770 Buford Highway NE, Atlanta, GA 30341, USA.
Cancer Epidemiol. 2011 Apr;35(2):112-9. doi: 10.1016/j.canep.2010.07.001. Epub 2010 Jul 31.
To examine the risk of subsequent primary ovarian cancer among women diagnosed previously with cancer (subsequent cohort) and to compare demographic and tumor characteristics affecting overall survival of these women and women diagnosed with first primary ovarian cancer (index cohort).
We identified the two cohorts of women using the 1973-2005 Surveillance, Epidemiology and End Results (SEER) result data. We calculated relative risk of subsequent primary ovarian cancer and estimated 5-year risks of dying (hazard-ratios) after diagnosis of the first or subsequent primary ovarian cancer in the two cohorts, respectively using Cox modeling.
Women diagnosed with index cancers of the corpus uteri, colon, cervix, and melanoma at age younger than 50 had increased risk of ovarian cancer within 5 years after diagnosis (p<0.05); young breast cancer survivors had continued risk beyond 20 years. In 5-year follow-up survival analysis, the factors associated with a better survival (p<0.05) were similar in both cohorts and included more recent diagnosis; localized or regional disease; age <50 years at diagnosis; and being white versus black. A lower risk of dying from mucinous, endometrioid, or non-epithelial tumors than from serous was seen after 15 months (p<0.01), or after 32 months from diagnosis of the index and subsequent cohorts, respectively.
Age, stage, and histology affect ovarian cancer survival. The increased risk of ovarian cancer over time, especially among breast and colon cancer survivors who are less than 50 years of age, suggests common etiologies and necessitates careful surveillance by health care providers and increased survivors awareness through educational efforts.
研究先前患有癌症（后续队列）的女性中随后原发性卵巢癌的风险，并比较影响这些女性和首次诊断为原发性卵巢癌（索引队列）的女性总生存的人口统计学和肿瘤特征。
我们使用 1973-2005 年监测、流行病学和最终结果（SEER）结果数据确定了这两个队列的女性。我们使用 Cox 建模分别计算了两个队列中首次或随后原发性卵巢癌诊断后 5 年内随后原发性卵巢癌的相对风险和估计死亡风险（风险比）。
50 岁以下诊断为子宫体、结肠、宫颈和黑色素瘤的索引癌症的女性在诊断后 5 年内患卵巢癌的风险增加（p<0.05）；年轻的乳腺癌幸存者在 20 年以上仍有持续的风险。在 5 年随访生存分析中，与生存较好相关的因素（p<0.05）在两个队列中相似，包括较近的诊断；局限性或区域性疾病；诊断时年龄<50 岁；以及与黑人相比为白人。与浆液性相比，黏液性、子宫内膜样或非上皮性肿瘤在 15 个月（p<0.01）或诊断后 15 个月后分别从索引和随后队列的诊断开始 32 个月后，死亡风险降低。
年龄、分期和组织学影响卵巢癌的生存。随着时间的推移，卵巢癌的风险增加，特别是在 50 岁以下的乳腺癌和结肠癌幸存者中，这表明存在共同的病因，并需要医疗保健提供者进行仔细的监测，并通过教育努力提高幸存者的意识。
