Abstract 3289: Time to diagnosis of second primary cancers among survivors of smoking-related malignancies
Authors: Boakye Eric Adjei , Osazuwa-Peters Nosayaba , Lee Min Jee , Ganai Sabha , Wang Maggie , Simpson Matthew C. , Jenkins Wiley D. 
Published: August 2019

Background: Despite steady declines in cigarette smoking prevalence, approximately one-third of cancer deaths in the United States are associated with smoking. This growing population of cancer survivors is at increased risk of developing second primary cancers (SPCs). We explored the incidence of SPC by latency period among survivors of the most commonly diagnosed smoking-related malignancies.

Methods: The current study utilized Surveillance, Epidemiology, and End Results data (2000-2015) concerning diagnoses with a primary malignancy from 10 smoking-related cancer sites (lung and bronchus, head and neck, esophagus, urinary bladder, liver, stomach, kidney and renal pelvis, acute myeloid leukemia, uterine cervix, and colorectal). SPC was defined as the first subsequent primary cancer occurring at least 2 months after first cancer diagnosis. SPC risks were quantified using standardized incidence ratios (SIRs) stratified by latency period (&lt;1 year, 1-5 years, 5-10 years, 10+ years).

Results: A cohort of 1,895,307 patients was identified and 132,635 (7.0%) developed SPC. Overall risk of SPC for all primary smoking-related malignancy was significantly elevated for all latency periods compared with the general population. Almost all smoking-related cancer sites presented with a significant increase in the risk of SPC relative to the general population (SIR range 1.09-3.38) within the first 5 years (with the exception of acute myeloid leukemia cancer) and individual cancer risk declined with increasing latency (Table).

Conclusion: We found that 1-in-12 survivors of smoking-related primary malignancies developed an SPC. For most such malignancies, the risk of SPC was higher within 5 years after the primary diagnosis and declined with increasing latency. As cancer survivors transition back to primary care management in the years following cancer cure/remission, a better understanding of SPC risk and associated factors is needed to inform surveillance and prevention guidelines.

Risk of second primary cancers for smoking-related malignancies&lt;1 year1-5 years5-10 years10+ yearsIndex smoking-related cancerObserved SPCSIR (95% CI)Observed SPCSIR (95% CI)Observed SPCSIR (95% CI)Observed SPCSIR (95% CI)All smoking-related cancers30,6521.81 (1.79, 1.83)62,5871.45 (1.44, 1.46)31,2051.35 (1.33, 1.36)8,1911.23 (1.20, 1.26)Lung and bronchus5,7071.26 (1.23, 1.29)11,3601.59 (1.57, 1.62)5,2052.09 (2.03, 2.14)1,1062.03 (1.91, 2.15)Urinary bladder9,2043.38 (3.31, 3.45)13,3611.58 (1.55, 1.61)6,2451.30 (1.27, 1.33)1,5861.17 (1.11, 1.23)Head and neck3,1302.01 (1.94, 2.08)8,9532.00 (1.96, 2.04)4,9941.98 (1.93, 2.04)1,3081.78 (1.69, 1.88)Kidney & renal pelvis3,4872.49 (2.41, 2.58)6,2991.42 (1.39, 1.46)3,2431.26 (1.22, 1.30)8181.16 (1.09, 1.25)Uterine cervix4832.20 (2.01, 2.41)1,0661.54 (1.45, 1.65)6731.29 (1.19, 1.39)2621.17 (1.04, 1.32)Colon & rectum6,8081.39 (1.36, 1.43)18,0031.18 (1.16, 1.20)9,4451.03 (1.01, 1.06)2,7650.99 (0.95, 1.02)Liver3361.24 (1.11, 1.38)5431.23 (1.13, 1.34)1561.06 (0.90, 1.24)571.09 (0.82, 1.41)Esophagus4351.12 (1.02, 1.23)8241.39 (1.29, 1.49)3361.48 (1.33, 1.65)751.29 (1.02, 1.61)Stomach6791.09 (1.01, 1.17)1,5551.26 (1.20, 1.33)6571.17 (1.08, 1.26)1661.14 (0.97, 1.33)Acute myeloid leukemia1721.11 (0.95, 1.29)2671.14 (1.01, 1.28)1241.09 (0.90, 1.30)501.27 (0.94, 1.67)

Citation Format: Eric Adjei Boakye, Nosayaba Osazuwa-Peters, Min Jee Lee, Sabha Ganai, Maggie Wang, Matthew C. Simpson, Wiley D. Jenkins. Time to diagnosis of second primary cancers among survivors of smoking-related malignancies [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr 3289.