Huang Yuanhui, Lin Jenny J, Wisnivesky Juan P, Kong Chung Yin, Sigel Keith
Graduate School of Biomedical Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Division of Hematology and Medical Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
BJC Rep. 2025 May 15;3(1):33. doi: 10.1038/s44276-025-00151-4.
Breast cancer (BC) survivors may be at increased risk of developing second cancers compared to those without BC diagnosis due to shared risk factors and potential carcinogenic effects of cancer therapy. Lung cancer (LC) is the most common second primary cancer among BC survivors. This study aimed to evaluate the association between BC and the subsequent incidence of LC.
Women aged 55-74 were identified from the Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial. The risk of incident LC was compared by BC status using a multivariable Cox regression model with BC and smoking exposures incorporated as time-updated variables.
75,951 females from the PLCO trial were identified, with 5808 diagnosed with BC after enrollment. The unadjusted incidence rate (IR) of the second LC was significantly higher among BC survivors than non-BC participants (231 vs. 172 per 100,000 person-years). The adjusted hazard ratio (HR) for the second primary LC associated with BC diagnosis was 1.24 (95% CI: 1.03-1.49).
BC diagnosis was an independent risk factor for the development of second primary LC. Consequently, BC survivors may derive benefits from enhanced LC screening interventions.
与未被诊断为乳腺癌（BC）的人群相比，乳腺癌幸存者由于存在共同的风险因素以及癌症治疗可能产生的致癌作用，发生第二种癌症的风险可能更高。肺癌（LC）是乳腺癌幸存者中最常见的第二种原发性癌症。本研究旨在评估乳腺癌与随后肺癌发病之间的关联。
从前列腺、肺、结肠直肠和卵巢（PLCO）癌症筛查试验中确定年龄在55 - 74岁之间的女性。使用多变量Cox回归模型，将乳腺癌和吸烟暴露作为时间更新变量，根据乳腺癌状态比较肺癌发病风险。
在PLCO试验中确定了75,951名女性，其中5808名在入组后被诊断为乳腺癌。乳腺癌幸存者中第二种肺癌的未调整发病率（IR）显著高于非乳腺癌参与者（每100,000人年分别为231例和172例）。与乳腺癌诊断相关的第二种原发性肺癌的调整后风险比（HR）为1.24（95%CI：1.03 - 1.49）。
乳腺癌诊断是第二种原发性肺癌发生的独立危险因素。因此，乳腺癌幸存者可能会从强化的肺癌筛查干预措施中获益。
