Abstract：
OBJECTIVE: The purpose of the study is to assess the global risk of extracolonic secondary primary cancers (SPCs) in patients with colorectal cancer (CRC).
METHODS: Studies of SPC in patients with CRC were included if they reported the standardised incidence ratio (SIR) for extracolonic SPCs in patients with CRC compared with the general population. Pooled summary estimates were calculated using a random-effects model.
RESULTS: A total of 7,716,750 patients with CRC from 13 retrospective cohort studies that reported extracolonic SPC incidence were included. The overall risk of several SPCs was significantly higher in patients with CRC compared with the general population, including cancers of the urinary bladder (pooled SIR 1.19, 95% confidence interval (CI) 1.06-1.33; p = 0.003), female genital tract (1.88, 1.07-3.31; p = 0.03), kidney (1.50, 1.19-1.89; p = 0.0007), thorax (lung, bronchus and mediastinum) (1.16, 1.01-1.32; p = 0.03), small intestine (4.26, 2.58-7.01; p < 0.0001), stomach (1.22, 1.07-1.39; p = 0.003), and thyroid (1.40, 1.28-1.53; p < 0.0001), as well as melanoma (1.28, 1.01-1.62; p = 0.04). There was also a decreased risk of developing cancer of the gall bladder (0.75, 0.60-0.94; p = 0.01).
CONCLUSIONS: Patients with CRC had a significantly increased risk of extracolonic SPCs compared with the general population. These findings highlight the need to develop research strategies for the management of second primary cancer in patients with CRC.
METHODS: Studies of SPC in patients with CRC were included if they reported the standardised incidence ratio (SIR) for extracolonic SPCs in patients with CRC compared with the general population. Pooled summary estimates were calculated using a random-effects model.
RESULTS: A total of 7,716,750 patients with CRC from 13 retrospective cohort studies that reported extracolonic SPC incidence were included. The overall risk of several SPCs was significantly higher in patients with CRC compared with the general population, including cancers of the urinary bladder (pooled SIR 1.19, 95% confidence interval (CI) 1.06-1.33; p = 0.003), female genital tract (1.88, 1.07-3.31; p = 0.03), kidney (1.50, 1.19-1.89; p = 0.0007), thorax (lung, bronchus and mediastinum) (1.16, 1.01-1.32; p = 0.03), small intestine (4.26, 2.58-7.01; p < 0.0001), stomach (1.22, 1.07-1.39; p = 0.003), and thyroid (1.40, 1.28-1.53; p < 0.0001), as well as melanoma (1.28, 1.01-1.62; p = 0.04). There was also a decreased risk of developing cancer of the gall bladder (0.75, 0.60-0.94; p = 0.01).
CONCLUSIONS: Patients with CRC had a significantly increased risk of extracolonic SPCs compared with the general population. These findings highlight the need to develop research strategies for the management of second primary cancer in patients with CRC.
摘要：
目的：本研究的目的是评估结直肠癌（CRC）患者发生结肠外继发性原发癌（SPCs）的总体风险。
方法：如果报告CRC患者结肠外SPCs与普通人群相比的标准化发生率（SIR），则纳入CRC患者SPC的研究。汇总汇总估计值是使用随机效应模型计算的。
结果：纳入了13项回顾性队列研究报告结肠外SPC发生率的7,716,750例CRC患者。与普通人群相比，CRC患者中几种SPCs的总体风险明显更高。包括膀胱癌（合并SIR1.19，95％置信区间（CI）1.06-1.33；p=0.003），女性生殖道（1.88，1.07-3.31;p=0.03），肾（1.50，1.19-1.89；p=0.0007），胸部（肺，支气管和纵隔）（1.16，1.01-1.32；p=0.03），小肠（4.26，2.58-7.01；p<0.0001），胃（1.22，1.07-1.39；p=0.003），和甲状腺（1.40，1.28-1.53；p<0.0001），以及黑色素瘤（1.28，1.01-1.62；p=0.04）。发生胆囊癌的风险也降低（0.75，0.60-0.94；p=0.01）。
结论：与普通人群相比，CRC患者结肠外SPCs的风险显著增加。这些发现强调了需要制定研究策略来管理CRC患者的第二原发癌。
方法：如果报告CRC患者结肠外SPCs与普通人群相比的标准化发生率（SIR），则纳入CRC患者SPC的研究。汇总汇总估计值是使用随机效应模型计算的。
结果：纳入了13项回顾性队列研究报告结肠外SPC发生率的7,716,750例CRC患者。与普通人群相比，CRC患者中几种SPCs的总体风险明显更高。包括膀胱癌（合并SIR1.19，95％置信区间（CI）1.06-1.33；p=0.003），女性生殖道（1.88，1.07-3.31;p=0.03），肾（1.50，1.19-1.89；p=0.0007），胸部（肺，支气管和纵隔）（1.16，1.01-1.32；p=0.03），小肠（4.26，2.58-7.01；p<0.0001），胃（1.22，1.07-1.39；p=0.003），和甲状腺（1.40，1.28-1.53；p<0.0001），以及黑色素瘤（1.28，1.01-1.62；p=0.04）。发生胆囊癌的风险也降低（0.75，0.60-0.94；p=0.01）。
结论：与普通人群相比，CRC患者结肠外SPCs的风险显著增加。这些发现强调了需要制定研究策略来管理CRC患者的第二原发癌。
