Bergfeldt K, Einhorn S, Rosendahl I, Hall P
Department of General Oncology, Radiumhemmet, Karolinska Hospital, Stockholm, Sweden.
Acta Oncol. 1995;34(6):771-7. doi: 10.3109/02841869509127185.
The Stockholm-Gotland Cancer Register was used to study the risk of developing second primary malignancies (SPM) in women diagnosed with cancer of the uterine cervix, uterine corpus and ovaries during the period 1958-1992. Among 5,325 patients with uterine cervix cancer, 619 developed SPM. Standardized incidence ratio (SIR) was 1.29 (95% confidence interval (CI) 1.19-1.39). Significantly increased risks were observed for cancer of the colon, rectum, lung, vulva, kidney and bladder. A total of 4,815 women with uterine corpus cancer were followed and 660 SPM were found. The overall SIR was 1.21 (95% CI 1.12-1.30) with significantly increased risk for cancer of the colon, ovary, vulva and bladder. The incidence of leukemia was also significantly elevated (SIR = 3.03; 95% CI 1.70-5.00). Among 5,060 patients with ovarian cancer, 379 SPM were found (SIR 1.49; 95% CI 1.34-1.64). Increased risks of cancer of the colon, rectum, breast, uterine corpus, bladder and leukemia were observed. All three primary sites showed elevated risks of cancer of the colon and bladder. For patients with a primary cancer of the corpus and ovary an elevated risk of leukemia was also noted. The conclusion from these findings is that SPM to some extent can be explained by previously known factors, i.e. treatment and common risk factors. However, further studies concerning the role of common etiology, for instance hereditary and hormonal factors, are needed to increase the knowledge on the etiology of second primary malignancies.
斯德哥尔摩-哥特兰癌症登记处用于研究1958年至1992年期间被诊断患有子宫颈癌、子宫体癌和卵巢癌的女性发生第二原发性恶性肿瘤（SPM）的风险。在5325例子宫颈癌患者中，619例发生了SPM。标准化发病率比（SIR）为1.29（95%置信区间（CI）1.19 - 1.39）。观察到结肠癌、直肠癌、肺癌、外阴癌、肾癌和膀胱癌的风险显著增加。共对4815例子宫体癌女性进行了随访，发现660例SPM。总体SIR为1.21（95%CI 1.12 - 1.30），结肠癌、卵巢癌、外阴癌和膀胱癌的风险显著增加。白血病的发病率也显著升高（SIR = 3.03；95%CI 1.70 - 5.00）。在5060例卵巢癌患者中，发现379例SPM（SIR 1.49；95%CI 1.34 - 1.64）。观察到结肠癌、直肠癌、乳腺癌、子宫体癌、膀胱癌和白血病的风险增加。所有三个原发部位的结肠癌和膀胱癌风险均升高。对于患有子宫体癌和卵巢癌的患者，白血病风险也有所升高。这些发现得出的结论是，SPM在一定程度上可以由先前已知的因素来解释，即治疗和常见风险因素。然而，需要进一步研究常见病因的作用，例如遗传和激素因素，以增加对第二原发性恶性肿瘤病因的认识。
