Storm H H, Ewertz M
Natl Cancer Inst Monogr. 1985 Dec;68:331-40.
Between 1943 and 1980, approximately 53,000 women in Denmark survived 2 or more months after initial diagnosis of cancers of the cervix uteri, corpus uteri, ovaries, fallopian tubes, and ligaments. No significant excess of new cancers was observed following cancers of the cervix and corpus uteri. However, after second cancers of both the cervix and corpus uteri were eliminated from the analysis (because it was likely they were surgically removed or not recorded due to conservative coding practices), 6 and 4% excess risks of borderline significance were found among women with cancer of the cervix and uterus, respectively. A significant 25% excess of all second primary cancers was observed following cancer of the ovary (relative risk = 1.25; 95% CI = 1.14-1.37). Significant excesses of colon and breast cancers followed cancers of the ovary and corpus uteri. Subsequent to cervical cancer, the risk of cancers of the lung, esophagus, bladder, and kidney occurred significantly above expectation. These associations may be explained by common risk factors related to reproduction and possibly diet for cancers of the breast, colon, ovary, and corpus uteri; and to cigarette smoking for cancers of the lung, esophagus, bladder, and cervix uteri. The significant deficit of breast cancer after cervical cancer could be due to different patterns of risk factor (i.e., reproductive and socioeconomic variables) and loss of functioning ovaries as a part of the treatment for cervical cancer. Each of the female genital sites showed significant excesses of second bladder cancers, and the risk increased significantly with time, which indicate a relation to radiotherapy. The pattern of risk of leukemia observed following cancer of the ovary was also compatible with effects of treatment, especially chemotherapy.
1943年至1980年间，丹麦约53,000名女性在初次诊断为子宫颈癌、子宫体癌、卵巢癌、输卵管癌和韧带癌后存活了2个月或更长时间。子宫颈癌和子宫体癌之后未观察到新癌症的显著增加。然而，在从分析中排除子宫颈癌和子宫体癌的二次癌症后（因为它们可能已通过手术切除或由于保守编码做法未被记录），子宫颈癌和子宫体癌女性中分别发现了边缘性显著的6%和4%的额外风险。卵巢癌之后观察到所有第二原发性癌症显著增加25%（相对风险 = 1.25；95%置信区间 = 1.14 - 1.37）。卵巢癌和子宫体癌之后结肠癌和乳腺癌显著增加。子宫颈癌之后，肺癌、食管癌、膀胱癌和肾癌的风险显著高于预期。这些关联可能由与生殖相关的常见风险因素以及可能与乳腺癌、结肠癌、卵巢癌和子宫体癌的饮食有关；与肺癌、食管癌、膀胱癌和子宫颈癌的吸烟有关来解释。子宫颈癌后乳腺癌的显著不足可能是由于风险因素模式不同（即生殖和社会经济变量）以及作为子宫颈癌治疗一部分的卵巢功能丧失。每个女性生殖部位的膀胱癌二次发病均显著增加，且风险随时间显著增加，这表明与放疗有关。卵巢癌后观察到的白血病风险模式也与治疗效果相符，尤其是化疗。
