Cancer Epidemiology Group, Division of Cancer Studies, School of Medicine, King's College London, London, United Kingdom.
Cancer. 2012 Dec 15;118(24):6207-16. doi: 10.1002/cncr.27672. Epub 2012 Jun 6.
The occurrence of multiple cancers may indicate common etiology; and, although some studies have investigated the risk of second primary cancers after prostate cancer (PCa), there are no studies on cancers before PCa.
The PCBaSe Sweden database is based on the National Prostate Cancer Register (NPCR), which covers >96% of PCa cases. The authors estimated the prevalence and cumulative incidence of different cancers before and after PCa diagnosis in 72,613 men according to PCa treatment and disease stage in PCBaSe and their matched comparison cohort of men who were free of PCa.
In total, 6829 men were diagnosed with another primary cancer before their PCa diagnosis, including 138 men at the time of PCa diagnosis and 5230 men were diagnosed after PCa diagnosis. Cancer of the bladder or colon and nonmelanoma of the skin were the 3 most frequently observed cancers before and after PCa diagnosis. At the time of PCa diagnosis, the prevalence of these 3 cancers was 1.94% for bladder cancer, 1.08% for colon cancer, and 1.08% for nonmelanoma skin cancer, compared with 1.30%, 0.96%, and 1.03%, respectively, for the matched comparison cohort. Five years after PCa diagnosis, the difference in incidence proportion between PCa men and their comparison cohort was 7 ‰ (95% CI, 5.6 ‰-8.5 ‰), 1.3 ‰ (0 ‰-2.6 ‰), and 1.6 ‰ (0.6 ‰-2.6 ‰) for these 3 cancers, respectively. From a uro-oncologic point of view, it is interesting to note that the prevalence of kidney cancer at the time of PCa diagnosis was 0.42% compared with 0.28% for the matched comparison cohort.
Approximately 17% of all PCa occurred in combination with another primary cancer (before or after PCa diagnosis). Detection bias probably explains part of this observation, but further investigations are required to assess possible underlying mechanisms.
多种癌症的发生可能表明存在共同的病因；尽管一些研究已经调查了前列腺癌（PCa）后第二原发癌的风险，但针对 PCa 之前的癌症的研究还没有。
PCBaSe 瑞典数据库基于国家前列腺癌登记处（NPCR），该登记处涵盖了>96%的 PCa 病例。作者根据 PCBaSe 中 PCa 的治疗和疾病阶段以及他们匹配的无 PCa 男性对照组，估计了 72613 名男性中 PCa 诊断前后不同癌症的患病率和累积发病率。
共有 6829 名男性在诊断为 PCa 之前被诊断出患有另一种原发性癌症，其中 138 名男性在诊断为 PCa 时被诊断出，5230 名男性在诊断为 PCa 后被诊断出。膀胱癌或结肠癌和非黑色素瘤皮肤癌是 PCa 诊断前后最常观察到的 3 种癌症。在诊断为 PCa 时，这 3 种癌症的患病率分别为膀胱癌 1.94%、结肠癌 1.08%和非黑色素瘤皮肤癌 1.08%，而在匹配的对照组中，这 3 种癌症的患病率分别为 1.30%、0.96%和 1.03%。在 PCa 诊断后 5 年，PCa 男性与对照组的发病率比例差异分别为 7 ‰（95%CI，5.6 ‰-8.5 ‰）、1.3 ‰（0 ‰-2.6 ‰）和 1.6 ‰（0.6 ‰-2.6 ‰）。从尿路上皮肿瘤学的角度来看，有趣的是，在诊断为 PCa 时，肾癌的患病率为 0.42%，而对照组为 0.28%。
大约 17%的所有 PCa 与另一种原发性癌症（在 PCa 诊断之前或之后）同时发生。检测偏倚可能部分解释了这一观察结果，但需要进一步调查以评估可能存在的潜在机制。
