目的:探讨肾细胞癌(RCC)患者发生第二原发癌的风险。
方法:我们使用以人群为基础的丹麦医学登记册,确定了1995-2019年期间所有诊断为肾癌的患者。从RCC诊断之日起随访患者,直到任何第二原发癌诊断,死亡,移民,或2019年12月31日,以先到者为准。我们计算了绝对风险,标准化发病率(SIR),第二原发癌的绝对风险过高,95%置信区间(CI),RCC患者与普通人群相比。
结果:任何第二原发癌的1年和20年绝对风险分别为2.8%和17.8%,分别。RCC诊断后1年内,我们每1000人年检测到20例癌症病例(PY)(SIR,2.3;95%CI:2.1-2.6)。此外,在1至<5年的随访期间,我们每1000PY又检测到4例癌症病例(SIR,1.3;95%CI:1.2-1.4),在5年的随访后,每1000日元中有6日元(SIR,1.4;95%CI:1.3-1.5)。超过1年随访的癌症风险持续升高主要归因于肺癌和膀胱癌的过度风险。2006-2019年第二原发癌的风险高于1995-2005年,但仅在随访的第一年。
结论:发生肾癌的患者第二原发癌的长期风险持续升高40%,与普通人群相比。这种增加的风险主要归因于肺癌和膀胱癌。
OBJECTIVE: To examine the risk of second primary cancer in patients with incident renal cell carcinoma (RCC).
METHODS: We identified all patients diagnosed with incident RCC during 1995-2019, using population-based Danish medical registries. Patients were followed from the date of RCC diagnosis until any second primary cancer diagnosis, death, emigration, or December 31, 2019, whichever came first. We computed the absolute risk, standardized incidence ratio (SIR), and excess absolute risk of second primary cancer, with 95% confidence intervals (CIs), among patients with RCC compared to the general population.
RESULTS: The absolute 1- and 20-year risks of any second primary cancer were 2.8% and 17.8%, respectively. Within 1 year after RCC diagnosis, we detected 20 excess cancer cases per 1000 person-years (PY) (SIR, 2.3; 95% CI: 2.1-2.6). Moreover, we detected an additional four excess cancer cases per 1000 PY during 1 to <5 years of follow-up (SIR, 1.3; 95% CI: 1.2-1.4), and 6 per 1000 PY beyond 5 years of follow-up (SIR, 1.4; 95% CI: 1.3-1.5). The sustained elevated cancer risk beyond 1 year of follow-up was mainly attributed to excess risk of lung and bladder cancer. The risk of second primary cancer was higher in 2006-2019 than in 1995-2005, but only during the first year of follow-up.
CONCLUSIONS: Patients with incident RCC have a sustained 40% elevated long-term risk of second primary cancer, compared with the general population. This increased risk is mainly attributed to lung and bladder cancer.