Bjørge T, Hennig E M, Skare G B, Søreide O, Thoresen S O
Cancer Registry of Norway, Institute for Epidemiological Cancer Research, Montebello, Oslo.
Int J Cancer. 1995 Jul 4;62(1):29-33. doi: 10.1002/ijc.2910620108.
Multiple primary cancers in the same individual occur rarely. Consequently, a large number of cancer patients have to be followed for long periods to obtain adequate information about their risk of subsequent tumour development. Studies of multiple malignancies are of interest, since they may provide information on common or opposite risk factors. In the present study, the risk of second primary cancers following carcinoma in situ of the uterine cervix diagnosed in Norway in the period 1970-1992 was examined and quantified. Altogether, 37,001 patients with carcinoma in situ were followed from the date of diagnosis until 31 December 1992. The follow-up period was divided into 5-year intervals. The results were expressed as standardized incidence ratios (SIR = O/E), and their 95% confidence intervals were given. A total of 1,037 second primary cancers in 989 individuals were identified. There was no overall excess of second primary cancers. However, there were differences depending on the site: cancers of the oesophagus, nose, nasal cavities, trachea, bronchus, lung, vulva, vagina, bladder and other urinary organs, and other skin cancers, excluding basal-cell carcinoma, occurred more frequently. A lower risk than expected was noted for cancer of the cervix uteri and cancer of the corpus uteri. There was a rising trend with time in the observed/expected ratio for cancer of urinary organs. In the group of patients evaluated, the likelihood of subsequent tumour development was no greater than in the general female population. Nevertheless, cancer sites of higher and of lower risk than expected were identified among the carcinoma-in situ patients.
同一个体发生多种原发性癌症的情况很少见。因此，必须对大量癌症患者进行长期随访，以获取有关他们后续发生肿瘤风险的充分信息。对多种恶性肿瘤的研究很有意义，因为它们可能提供关于共同或相反风险因素的信息。在本研究中，对1970年至1992年期间在挪威诊断出的子宫颈原位癌患者发生第二原发性癌症的风险进行了检查和量化。总共对37,001例原位癌患者从诊断之日起随访至1992年12月31日。随访期分为5年间隔。结果以标准化发病率比（SIR = O/E）表示，并给出其95%置信区间。共识别出989例个体中的1,037例第二原发性癌症。第二原发性癌症总体上没有超额发生。然而，根据部位存在差异：食管、鼻、鼻腔、气管、支气管、肺、外阴、阴道、膀胱和其他泌尿器官的癌症以及其他皮肤癌（不包括基底细胞癌）发生频率更高。子宫颈癌和子宫体癌的风险低于预期。泌尿器官癌症的观察/预期比值随时间呈上升趋势。在评估的患者组中，后续发生肿瘤的可能性不高于一般女性人群。尽管如此，在原位癌患者中还是识别出了风险高于和低于预期的癌症部位。
