乳腺癌患者发生第二原发性癌症的风险：一项系统评价和荟萃分析。
Risk of second primary cancer among breast cancer patients: A systematic review and meta-analysis.
作者信息
Parhizgar Parynaz, Bahadori Monfared Ayad, Mohseny Maryam, Keramatinia Aliasghar, Hashemi Nazari Seyed Saeed, Rahman Syed Azizur, Al Marzouqi Amina, Al-Yateem Nabeel, Mosavi Jarrahi Alireza
机构信息
School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Department of Social Medicine, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
出版信息
Front Oncol. 2023 Jan 17;12:1094136. doi: 10.3389/fonc.2022.1094136. eCollection 2022.
OBJECTIVES
The aim of this study was to estimate the extra risk of second primary cancer among breast cancer patients.
METHODS AND MATERIALS
This is a systematic review. A comprehensive search of literature was performed in PubMed, Web of Science, Cochrane library, and Scopus. The search included all published studies up to October 2022. This systematic review included studies published in the English language that reported the risk of second primary non-breast cancer [, standardized incidence ratio (SIR)] among breast cancer patients older than 15 years. After evaluating the methodological quality of the selected studies, SIRs were pooled with consideration of heterogeneity among studies. The estimates were pooled by age and time since the diagnosis of primary breast cancer for both sexes (male and female). Age was categorized based on before 50 years and after 50 years, and time was categorized as duration of less than and more than 10 years, respectively.
RESULTS
From 2,484 articles, 30 articles were eligible for inclusion in the systematic review and meta-analysis. The studies varied in terms of population, number of cases, study design, setting, and year of implementation of the research. The estimated SIR for men and women was 1.28 (95% CI: 1.18, 1.38) and 1.27 (95% CI: 1.15, 1.39), respectively. Women diagnosed with breast cancer before menopause [SIR: 1.52 (95% CI: 1.34, 1.71) . 1.21 (95% CI: 1.08, 1.34)] as well as women after 10 years since their breast cancer diagnosis [1.33 (95% CI: 1.22, 1.431) . 1.24 (95% CI: 1.10, 1.37)] were at a higher risk of developing second primary cancer. Among men, while there were no differences in risk based on age, with the increase of time, the risk of second primary cancer was reduced [SIR: 1.22 (95% CI: 1.12, 1.33) . 1.00 (95% CI: 0.79, 1.22)].
CONCLUSION
There is an extra risk of second primary cancer among breast cancer patients. The extra risk should be considered for further screening and preventive measures among this population.
SYSTEMATIC REVIEW REGISTRATION
https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=336062, identifier (CRD42022336062).
目的
本研究旨在评估乳腺癌患者发生第二原发性癌症的额外风险。
方法与材料
这是一项系统评价。在PubMed、科学网、考克兰图书馆和Scopus中对文献进行了全面检索。检索涵盖截至2022年10月的所有已发表研究。该系统评价纳入了以英文发表的、报告了15岁以上乳腺癌患者发生第二原发性非乳腺癌风险[标准化发病比（SIR）]的研究。在评估所选研究的方法学质量后，考虑到研究之间的异质性对SIR进行了合并。按年龄以及自原发性乳腺癌诊断以来的时间对两性（男性和女性）的估计值进行了合并。年龄分为50岁之前和50岁之后，时间分别分为少于10年和多于10年。
结果
从2484篇文章中，有30篇文章符合纳入系统评价和荟萃分析的条件。这些研究在人群、病例数、研究设计、研究背景和研究实施年份方面存在差异。男性和女性的估计SIR分别为1.28（95%置信区间：1.18，1.38）和1.27（95%置信区间：1.15，1.39）。绝经前诊断为乳腺癌的女性[SIR：1.52（95%置信区间：1.34，1.71）. 1.21（95%置信区间：1.08，1.34）]以及乳腺癌诊断后10年以上的女性[1.33（95%置信区间：1.22，1.431）. 1.24（95%置信区间：1.10，1.37）]发生第二原发性癌症的风险更高。在男性中，虽然基于年龄的风险没有差异，但随着时间的增加，第二原发性癌症的风险降低了[SIR：1.22（95%置信区间：1.12，1.33）. 1.00（95%置信区间：0.79，1.22）]。
结论
乳腺癌患者存在发生第二原发性癌症的额外风险。对于该人群，应考虑这种额外风险以进行进一步筛查和采取预防措施。
系统评价注册
https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=336062，标识符（CRD42022336062）。
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