Department of Population Health Sciences, Weill Cornell Medicine, New York, NY, USA.
Quantitative Sciences Unit, Stanford University School of Medicine, Palo Alto, CA, USA.
JNCI Cancer Spectr. 2024 Sep 2;8(5). doi: 10.1093/jncics/pkae072.
Recent therapeutic advances have improved survival among lung cancer (LC) patients, who are now at high risk of second primary lung cancer (SPLC). Hispanics comprise the largest minority in the United States, who have shown a lower LC incidence and mortality than other races, and yet their SPLC risk is poorly understood. We quantified the SPLC incidence patterns among Hispanics vs other races.
We used data from the Multiethnic Cohort, a population-based cohort of 5 races (African American, Japanese American, Hispanic, Native Hawaiian, and White), recruited between 1993 and 1996 and followed through 2017. We identified patients diagnosed with initial primary lung cancer (IPLC) and SPLC via linkage to Surveillance, Epidemiology, and End Results registries. We estimated the 10-year cumulative incidence of IPLC (in the entire cohort) and SPLC (among IPLC patients). A standardized incidence ratio (SIR) was calculated as the ratio of SPLC-to-IPLC incidence by race and ethnicity.
Among 202 692 participants, 6788 (3.3%) developed IPLC over 3 871 417 person-years. The 10-year cumulative IPLC incidence was lower among Hispanics (0.80%, 0.72 to 0.88) vs Whites (1.67%, 1.56 to 1.78) or Blacks (2.44%, 2.28 to 2.60). However, the 10-year SPLC incidence following IPLC was higher among Hispanics (3.11%, 1.62 to 4.61) vs Whites (2.80%, 1.94 to 3.66) or Blacks (2.29%, 1.48 to 3.10), resulting in a significantly higher SIR for Hispanics (SIR = 8.27, 5.05 to 12.78) vs Whites (SIR = 5.60, 4.11 to 7.45) or Blacks (SIR = 3.48, 2.42 to 4.84; P < .001).
Hispanics have a higher SPLC incidence following IPLC than other races, which may be potentially due to better survival after IPLC and extended duration for SPLC development. Continuing surveillance is warranted to reduce racial disparities among LC survivors.
最近的治疗进展提高了肺癌 (LC) 患者的生存率，他们现在患第二原发性肺癌 (SPLC) 的风险很高。西班牙裔是美国最大的少数族裔，其 LC 发病率和死亡率低于其他种族，但他们的 SPLC 风险尚不清楚。我们量化了西班牙裔与其他种族之间的 SPLC 发病模式。
我们使用了多民族队列的数据，这是一个由 5 个种族（非裔美国人、日裔美国人、西班牙裔、夏威夷原住民和白人）组成的基于人群的队列，于 1993 年至 1996 年招募，并随访至 2017 年。我们通过与监测、流行病学和最终结果登记处的链接，确定了初始原发性肺癌 (IPLC) 和 SPLC 患者。我们估计了 IPLC（在整个队列中）和 SPLC（在 IPLC 患者中）的 10 年累积发病率。标准化发病率比 (SIR) 是通过种族和族裔计算的 SPLC 与 IPLC 发病率之比。
在 202692 名参与者中，有 6788 人（3.3%）在 3871417 人年中发展为 IPLC。西班牙裔的 10 年累积 IPLC 发病率较低（0.80%，0.72 至 0.88），而非裔（2.44%，2.28 至 2.60）或白人（1.67%，1.56 至 1.78）。然而，西班牙裔的 IPLC 后 SPLC 发病率较高（3.11%，1.62 至 4.61），而非裔（2.29%，1.48 至 3.10）或白人（2.80%，1.94 至 3.66），导致西班牙裔的 SIR 显著更高（SIR=8.27，5.05 至 12.78），而非裔（SIR=5.60，4.11 至 7.45）或白人（SIR=3.48，2.42 至 4.84；P<.001）。
西班牙裔患者 IPLC 后 SPLC 的发病率高于其他种族，这可能是由于 IPLC 后生存时间延长和 SPLC 发展时间延长所致。需要继续进行监测，以减少 LC 幸存者中的种族差异。
