Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, Brno, Czech Republic; Institute of Health Information and Statistics of the Czech Republic, Prague, Czech Republic.
Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, Brno, Czech Republic; Institute of Health Information and Statistics of the Czech Republic, Prague, Czech Republic.
Cancer Epidemiol. 2021 Jun;72:101929. doi: 10.1016/j.canep.2021.101929. Epub 2021 Apr 2.
Numbers of patients who develop subsequent primary tumours have markedly increased recently. This study aimed to carry out a comprehensive analysis documenting the risk of incidence of subsequent haematological malignancies.
The Czech National Cancer Registry was the main data source, containing records of 126,822 haematological malignancies diagnosed in the period 1977-2016. Subsequent haematological malignancies were identified according to IACR rules. Joinpoint regression was employed to assess the time trends. The risk of development of subsequent haematological malignancy was evaluated by the standardised incidence ratio. The Kaplan-Meier curves were used to assess the differences in survival.
Age-standardised incidence of subsequent haematological malignancies increased from 0.5 in 1977 to 9.1 in 2016. In 1992, there was a significant change in the trend: a sharp increase by 7.7 % annually was revealed thereafter. The risk of development of a haematological malignancy was approximately 1.5 times higher in persons with history of any cancer than in the general Czech population. Patients with haematological malignancies - mainly myelodysplastic syndromes, polycythaemia vera and non-Hodgkin lymphoma - were shown to be at the highest risk of developing a subsequent haematological malignancy. While the median survival following a first haematological malignancy was 2.3 years, it was only 1.1 years for subsequent haematological malignancies (p < 0.001).
Our study identified the highest-risk diagnoses in terms of development of subsequent haematological malignancy. The results might be useful to set up correctly follow-up procedures from which cancer patients could benefit.
近年来，继发原发性肿瘤的患者数量显著增加。本研究旨在进行全面分析，记录继发血液系统恶性肿瘤的发病风险。
捷克国家癌症登记处是主要的数据来源，包含了 1977 年至 2016 年间诊断的 126822 例血液系统恶性肿瘤的记录。根据 IACR 规则确定继发血液系统恶性肿瘤。采用 Joinpoint 回归评估时间趋势。通过标准化发病比评估继发血液系统恶性肿瘤的发病风险。采用 Kaplan-Meier 曲线评估生存差异。
继发血液系统恶性肿瘤的年龄标准化发病率从 1977 年的 0.5 上升至 2016 年的 9.1。1992 年，趋势发生了显著变化：此后每年急剧增加 7.7%。有癌症病史的个体发生血液系统恶性肿瘤的风险约为捷克普通人群的 1.5 倍。患有血液系统恶性肿瘤（主要是骨髓增生异常综合征、真性红细胞增多症和非霍奇金淋巴瘤）的患者发生继发血液系统恶性肿瘤的风险最高。继发血液系统恶性肿瘤的中位生存时间为 1.1 年，而首次血液系统恶性肿瘤后的中位生存时间为 2.3 年（p < 0.001）。
我们的研究确定了发展为继发血液系统恶性肿瘤的最高风险诊断。研究结果可能有助于制定正确的随访程序，使癌症患者受益。
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