McCredie M, Macfarlane G J, Bell J, Coates M
Cancer Epidemiology Research Unit, New South Wales Cancer Council, Woolloomooloo, Australia.
Cancer Epidemiol Biomarkers Prev. 1997 Mar;6(3):155-60.
Data from the New South Wales Central Cancer Registry for the period 1972-1991 were examined to determine the risk of second primary cancers after an initial invasive cancer of the colon (ICD-9 153) or rectum (ICD-9 154). The expected numbers of cancers were obtained by assuming that subjects experienced the same cancer incidence as prevailed in the corresponding general population and by applying sex-, age-, and calendar-specific rates to the appropriate person-years at risk. The relative risk (RR) of a second primary cancer was taken to be the ratio of observed:expected numbers of second cancers. After colon cancer, there was an excess of cancers of the small intestine in both sexes (RRs of 4.5 and 4.4); prostate (RR = 1.4) and kidney (RR = 1.8) in men; and breast (RR = 1.3), body of uterus (RR = 1.9), ovary (RR = 2.8), and thyroid (RR = 2.7) in women. Lung cancer occurred less frequently in men than expected (RR = 0.7). After rectal cancer, men had increased risks of cancers of the colon (RR = 1.5) and prostate (RR = 1.3) and a reduced risk of pancreatic cancer (RR = 0.3). A reciprocal relationship of increased risk was seen between cancers of the proximal (but not the distal) colon and rectum. Shared luminal risk factors for proximal colon cancer and rectal cancer and three syndromes of hereditary predisposition to colon cancer seem to be the major contributors to second primary cancers in patients with an initial colon cancer. Sources of bias have been considered.
对新南威尔士中央癌症登记处1972年至1991年期间的数据进行了检查，以确定在首次发生结肠浸润性癌（国际疾病分类第九版代码153）或直肠浸润性癌（国际疾病分类第九版代码154）后发生第二原发性癌症的风险。通过假设研究对象的癌症发病率与相应普通人群的发病率相同，并将性别、年龄和日历特定的发病率应用于适当的风险人年，得出癌症的预期数量。第二原发性癌症的相对风险（RR）被视为观察到的第二癌症数量与预期数量之比。结肠癌之后，男女两性的小肠癌均有超额发生（RR分别为4.5和4.4）；男性的前列腺癌（RR = 1.4）和肾癌（RR = 1.8）；女性的乳腺癌（RR = 1.3）、子宫体癌（RR = 1.9）、卵巢癌（RR = 2.8）和甲状腺癌（RR = 2.7）。男性肺癌的发生频率低于预期（RR = 0.7）。直肠癌之后，男性患结肠癌（RR = 1.5）和前列腺癌（RR = 1.3）的风险增加，患胰腺癌的风险降低（RR = 0.3）。在近端（而非远端）结肠癌和直肠癌之间发现了风险增加的相互关系。近端结肠癌和直肠癌的共同腔内风险因素以及三种遗传性结肠癌易患综合征似乎是初始结肠癌患者发生第二原发性癌症的主要原因。已考虑了偏倚来源。
