Risks of second primary cancers among 584,965 female and male breast cancer survivors in England: a 25-year retrospective cohort study.
Date
2024-05-01ICR Author
Author
Allen, I
Hassan, H
Joko-Fru, WY
Huntley, C
Loong, L
Rahman, T
Torr, B
Bacon, A
Knott, C
Jose, S
Vernon, S
Lüchtenborg, M
Pethick, J
Lavelle, K
McRonald, F
Eccles, D
Morris, EJA
Hardy, S
Turnbull, C
Tischkowitz, M
Pharoah, P
Antoniou, AC
Type
Journal Article
Metadata
Show full item recordAbstract
BACKGROUND: Second primary cancers (SPCs) after breast cancer (BC) present an increasing public health burden, with little existing research on socio-demographic, tumour, and treatment effects. We addressed this in the largest BC survivor cohort to date, using a novel linkage of National Disease Registration Service datasets. METHODS: The cohort included 581,403 female and 3562 male BC survivors diagnosed between 1995 and 2019. We estimated standardized incidence ratios (SIRs) for combined and site-specific SPCs using incidences for England, overall and by age at BC and socioeconomic status. We estimated incidences and Kaplan-Meier cumulative risks stratified by age at BC, and assessed risk variation by socio-demographic, tumour, and treatment characteristics using Cox regression. FINDINGS: Both genders were at elevated contralateral breast (SIR: 2.02 (95% CI: 1.99-2.06) females; 55.4 (35.5-82.4) males) and non-breast (1.10 (1.09-1.11) females, 1.10 (1.00-1.20) males) SPC risks. Non-breast SPC risks were higher for females younger at BC diagnosis (SIR: 1.34 (1.31-1.38) <50 y, 1.07 (1.06-1.09) ≥50 y) and more socioeconomically deprived (SIR: 1.00 (0.98-1.02) least deprived quintile, 1.34 (1.30-1.37) most). INTERPRETATION: Enhanced SPC surveillance may benefit BC survivors, although specific recommendations require more detailed multifactorial risk and cost-benefit analyses. The associations between deprivation and SPC risks could provide clinical management insights. FUNDING: CRUK Catalyst Award CanGene-CanVar (C61296/A27223). Cancer Research UK grant: PPRPGM-Nov 20∖100,002. This work was supported by core funding from the NIHR Cambridge Biomedical Research Centre (NIHR203312)]. The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care.
Collections
Subject
Breast cancer
Deprivation
Epidemiology
Incidence
Pathology
Risk
Second primary cancer
Treatment
Research team
Translational Genetics
Language
eng
Date accepted
2024-03-28
License start date
2024-05-01
Citation
The Lancet Regional Health - Europe, 2024, 40 pp. 100903 -
Publisher
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