Levi F, Randimbison L, Te V C, Rolland-Portal I, Franceschi S, La Vecchia C
Institut universitaire de médecine sociale et préventive, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.
Br J Cancer. 1993 Feb;67(2):391-5. doi: 10.1038/bjc.1993.72.
Data collected by the Cancer Registry of the Swiss Canton of Vaud (whose population in 1980 was about 530,000 inhabitants) were used to estimate the incidence of second metachronous primary cancers following any specific neoplasm. Among 34,615 cases of incident neoplasms registered between 1974 and 1989 and followed through integrated active follow-up to the end of 1989, for a total of 118,241 person-years at risk, there were 2,185 second primaries (1,280 males, 905 females). For both sexes, the standardised incidence ratios (SIR) were significantly elevated by about 20%. Overall significantly elevated ratios were registered for cancers of the oral cavity and pharynx (SIR = 1.6 for males, 2.0 for females), oesophagus in males (SIR = 1.5), lung in males (SIR = 1.4), skin melanoma (SIR = 1.7 for males, 1.5 for females), non-melanomatous skin cancers (SIR = 1.6 for males, 1.5 for females), female breast (SIR = 1.3), kidney (SIR = 1.5 for males, 1.9 for females), and thyroid in males (SIR = 2.4). When specific first cancer sites were considered, the SIR following a cancer of the oral cavity and pharynx was around 3 in both sexes, mainly on account of a substantial excess of second primaries of the oral cavity, oesophagus, larynx and lung. The overall SIR following laryngeal cancer was 3.0, and significant excesses were observed for oral cavity and pharynx, oesophagus and lung. After lung cancer, the overall SIR was 1.7 for males and 2.6 for females, and significantly elevated SIRs were observed for oral cavity, lung and oesophagus. Following non-melanomatous skin cancers, elevated SIRs were observed in both sexes for skin melanoma and non-melanomas. The incidence of any cancer after breast cancer was significantly elevated (SIR = 1.2), mainly on account of an elevated risk of subsequent breast cancer (SIR = 1.7). With reference to cervical cancer, there was a significant excess for any subsequent primary (SIR = 1.6), and for lung cancer (SIR = 7.8). Significantly elevated SIRs were observed for kidney following bladder cancer, and for bladder after kidney cancer. In both sexes, the incidence of cancers of any site was elevated following leukaemias (SIR = 1.7 for males, 2.5 for females), and a significant excess was registered for lung in males and non-melanomatous skin cancers in both sexes.(ABSTRACT TRUNCATED AT 400 WORDS)
瑞士沃州癌症登记处（1980年人口约53万居民）收集的数据被用于估计任何特定肿瘤后发生的异时性第二原发性癌症的发病率。在1974年至1989年间登记的34615例新发肿瘤病例中，通过综合主动随访至1989年底，总共有118241人年的风险期，其中有2185例第二原发性癌症（男性1280例，女性905例）。男女的标准化发病率（SIR）均显著升高约20%。总体而言，口腔和咽癌（男性SIR = 1.6，女性SIR = 2.0）、男性食管癌（SIR = 1.5）、男性肺癌（SIR = 1.4）、皮肤黑色素瘤（男性SIR = 1.7，女性SIR = 1.5）、非黑色素瘤皮肤癌（男性SIR = 1.6，女性SIR = 1.5）、女性乳腺癌（SIR = 1.3）、肾癌（男性SIR = 1.5，女性SIR = 1.9）以及男性甲状腺癌（SIR = 2.4）的发病率均显著升高。当考虑特定的第一癌症部位时，口腔和咽癌后的SIR在男女中均约为3，主要是因为口腔、食管、喉和肺癌的第二原发性癌症大量增加。喉癌后的总体SIR为3.0，口腔和咽、食管和肺癌的发病率显著增加。肺癌后，男性的总体SIR为1.7，女性为2.6，口腔、肺和食管癌的SIR显著升高。非黑色素瘤皮肤癌后，男女皮肤黑色素瘤和非黑色素瘤的SIR均升高。乳腺癌后的任何癌症发病率均显著升高（SIR = 1.2），主要是因为后续乳腺癌的风险升高（SIR = 1.7）。关于宫颈癌，任何后续原发性癌症（SIR = 1.6）以及肺癌（SIR = 7.8）的发病率均显著增加。膀胱癌后肾癌以及肾癌后膀胱癌的SIR均显著升高。男女白血病后的任何部位癌症发病率均升高（男性SIR = 1.7，女性SIR = 2.5），男性肺癌和男女非黑色素瘤皮肤癌的发病率显著增加。（摘要截短至400字）
