American Journal of Epidemiology Advance Access originally published online on January 18, 2006
American Journal of Epidemiology 2006 163(6):502-511; doi:10.1093/aje/kwj073
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Original Contribution |
A Pooled Analysis of Second Primary Pancreatic Cancer
1 International Agency for Research on Cancer, Lyon, France
2 Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD
3 Institute of Cancer Epidemiology, Danish Cancer Society, Copenhagen, Denmark
4 Institute of Population-based Cancer Research, Oslo, Norway
5 Division of Molecular Genetic Epidemiology, German Cancer Research Center, Heidelberg, Germany
6 Department of Biosciences at Novum, Karolinska Institute, Huddinge, Sweden
7 Finnish Cancer Registry, Institute for Statistical and Epidemiological Cancer Research, Helsinki, Finland
8 New South Wales Central Cancer Registry, Cancer Institute, Eveleigh, New South Wales, Australia
9 Scottish Cancer Registry, Information Services, National Health Service, Edinburgh, United Kingdom
10 British Columbia Cancer Agency, Vancouver, British Columbia, Canada
11 Cancer Registry of Slovenia, Institute of Oncology, Ljubljana, Slovenia
12 Epidemiology and Cancer Registry, CancerCare Manitoba, and Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
13 Saskatchewan Cancer Agency, Regina, Saskatchewan, Canada
14 Center for Molecular Epidemiology, National University of Singapore, and Singapore Cancer Registry, Singapore
15 Cancer Registry of Zaragoza, Health Department of Aragon Government, Zaragoza, Spain
16 Icelandic Cancer Registry, Icelandic Cancer Society, and Faculty of Medicine, University of Iceland, Reykjavik, Iceland
Correspondence to Dr. Min Shen, Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, MSC 7240, 6120 Executive Boulevard, Bethesda, MD 20892-7240 (e-mail: shenmi{at}mail.nih.gov).
Studies of pancreatic cancer in the setting of second primary malignant neoplasms can provide etiologic clues. An international multicenter study was carried out using data from 13 cancer registries with a registration period up to year 2000. Cancer patients were followed up from the initial cancer diagnosis, and the occurrence of second primary malignant neoplasms was compared with expected values derived from local rates, adjusting for age, sex, and period of diagnosis. Results from individual registries were pooled by use of a fixed-effects model. People were at higher risk of developing pancreatic cancer within 10 years of a diagnosis of cancers of the pharynx, stomach, gallbladder, larynx, lung, cervix, corpus uteri, bladder, and eye and 10 years or later following a diagnosis of cancers of the stomach, colon, gallbladder, breast, cervix, placenta, corpus uteri, ovary, testis, bladder, kidney, and eye, as well as Hodgkin's and non-Hodgkin's lymphomas. Pancreatic cancer was connected with smoking-related cancers, confirming the etiologic role of tobacco. The associations with uterine and ovarian cancers suggest that reproductive factors might be implicated in pancreatic carcinogenesis. The elevated pancreatic cancer risk in young patients observed among several types of cancer implies a role of genetic factors. Radiotherapy is also suggested as a risk factor.
neoplasms, second primary; pancreatic neoplasms; risk factors
Abbreviations: CI, confidence interval; SIR, standardized incidence ratio