美国亚裔亚群人群中卵巢癌治疗后的二次妇科癌症发病风险，2000-2016 年。
Risks of Second Primary Gynecologic Cancers following Ovarian Cancer Treatment in Asian Ethnic Subgroups in the United States, 2000-2016.
机构信息
University of Illinois at Chicago, College of Pharmacy, Chicago, Illinois.
University of Illinois Cancer Center, Chicago, Illinois.
出版信息
Cancer Epidemiol Biomarkers Prev. 2020 Nov;29(11):2220-2229. doi: 10.1158/1055-9965.EPI-20-0095. Epub 2020 Aug 20.
BACKGROUND
The differential occurrence of second primary cancers by race following ovarian cancer is poorly understood. Our objective was to determine the incidence of second primary gynecologic cancers (SPGC) following definitive therapy for ovarian cancer. Specifically, we aimed to determine differences in SPGC incidence by Asian ethnic subgroups.
METHODS
We identified 27,602 women ages 20 years and older and diagnosed with first primary epithelial ovarian cancer between 2000 and 2016 who received surgery and chemotherapy in 18 population-based Surveillance, Epidemiology and End Results Program registries. We compared the incidence of SPGC with expected incidence rates in the general population of women using estimated standardized incidence ratios (SIR) and 95% confidence intervals (CI).
RESULTS
The incidence of SPGC was lower among White women (SIR = 0.73; 95% CI, 0.59-0.89), and higher among Black (SIR = 1.80; 95% CI, 0.96-3.08) and Asian/Pacific Islander (API) women (SIR = 1.83; 95% CI, 1.07-2.93). Increased risk of vaginal cancers was observed among all women, although risk estimates were highest among API women (SIR = 26.76; 95% CI, 5.52-78.2) and were also significant for risk of uterine cancers (SIR = 2.53; 95% CI, 1.35-4.33). Among API women, only Filipinas had significantly increased incidence of SPGC overall including both uterine and vaginal cancers.
CONCLUSIONS
Risk of SPGC following treatment of ovarian cancer differs by race and ethnicity, with Filipina women having the highest rates of second gynecologic cancers among Asian women.
IMPACT
Ensuring access and adherence to surveillance may mitigate ethnic differences in the early detection and incidence of second gynecologic cancers.
背景
种族不同，卵巢癌患者接受治疗后发生第二原发癌的情况也不同，但目前人们对此知之甚少。本研究旨在明确卵巢癌患者接受明确治疗后发生第二原发妇科癌症（SPGC）的发病率，尤其旨在确定亚裔亚组之间 SPGC 发病率的差异。
方法
我们从 18 个基于人群的监测、流行病学和最终结果（SEER）计划登记处中确定了 2000 年至 2016 年间年龄在 20 岁及以上且接受过手术和化疗治疗、诊断为原发性上皮性卵巢癌的 27602 名女性。我们通过估计标准化发病比（SIR）及其 95%置信区间（CI），将 SPGC 的发生率与女性一般人群的预期发生率进行比较。
结果
白人女性 SPGC 发生率较低（SIR=0.73；95%CI，0.59-0.89），黑人（SIR=1.80；95%CI，0.96-3.08）和亚裔/太平洋岛民（API）女性（SIR=1.83；95%CI，1.07-2.93）发生率较高。所有女性的阴道癌发病风险均增加，尽管 API 女性的风险估计值最高（SIR=26.76；95%CI，5.52-78.2），API 女性的子宫癌风险也显著增加（SIR=2.53；95%CI，1.35-4.33）。在 API 女性中，仅菲律宾裔女性的 SPGC 总体发生率（包括子宫和阴道癌）显著增加。
结论
卵巢癌治疗后 SPGC 的发病风险因种族和民族而异，其中菲律宾裔女性的妇科第二原发癌发生率最高。
影响
确保接受和坚持监测可以减轻第二妇科癌症早期发现和发病率方面的种族差异。
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