AUTHOR=Corey Logan , Ruterbusch Julie , Shore Ron , Ayoola-Adeola Martins , Baracy Michael , Vezina Alex , Winer Ira 

TITLE=Incidence and Survival of Multiple Primary Cancers in US Women With a Gynecologic Cancer

JOURNAL=Frontiers in Oncology

VOLUME=Volume 12 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2022.842441

DOI=10.3389/fonc.2022.842441

ISSN=2234-943X

ABSTRACT=1.	Objectives
To evaluate risk of a second cancer and associated survival times in United States women with diagnosis of cancer. 

2.	Methods
The Surveillance Epidemiology and End Results (SEER) database was queried for 2 cohorts of women aged 18 - 89 with either an index gynecologic or non-gynecologic cancer diagnosed between 1992 – 2017. Index cases were followed to determine if a second primary cancer was subsequently diagnosed; defined according to SEER multiple primary and histology coding rules. Standard Incident Ratios (SIR) and latency intervals between index diagnosis and second primary diagnosis were evaluated. Among those who developed a second primary cancer, median survival times from diagnosis of second primary cancer were also calculated. 

3.	Results
Between 1992 – 2017, 227,313 US women were diagnosed with an index gynecological cancer and 1,483,016 were diagnosed with an index non-gynecologic cancer. Among patients with index gynecologic cancer, 7.78% developed a non-gynecologic subsequent primary cancer. The risk of developing any non-gynecologic cancer following an index gynecologic cancer was higher than the risk in the general population (SIR 1.05, 95% CI 1.04 - 1.07). The median latency period was 68 months between cancer diagnoses and the median survival was 60 months following the diagnosis of the second cancer. Among women diagnosed with an index non-gynecologic cancer, 0.99% were diagnosed with a subsequent gynecologic cancer. The risk of developing a gynecologic cancer following a non-gynecologic cancer was also elevated compared to the average risk of the general population (SIR 1.05, 1.03 - 1.07). The median latency was 68 months with a survival of 67 months following the second primary cancer diagnosis.

4.	Conclusion

The risk of a developing a second primary cancer and the corresponding survival time is based on the order and site of the index and subsequent cancer. Surveillance guidelines should be examined further to optimize survivorship programs.