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Table 2 MPCs following a first primary cancer at any site or a specific site

From: Temporal trends in the risk of developing multiple primary cancers: a systematic review

First author, Publication year, Institute,

STROBE criteria (met/total criteria)

First cancer diagnosis

Design Study period Follow-up

Patients, N

Patients with MPCs, N

Study population: definition and inclusion criteria

Definition of MPCs: inclusion criteria

Calendar year of first cancer diagnosis

Standardised incidence ratio (95%CI)

Relative risk (95%CI)

Any site

 Curtis RE et al. (2006) [7] SEER, U.S.

27/30

Any site

1973-2000

More than 2 million

185,407

The study population includes nearly 2 million cancer patients reported to the 9 SEER registries from 1973 to 2000, with follow-up for subsequent cancer occurrence extending up to 27 years.

MPC coding rules: SEER

1973-1979

1.12

 

1980-1984

1.14

1985-1989

1.14

1990-1994

1.14

1995-2000

1.21

 AIRTUM Working Group (2013) [57] Italian Association of Cancer Registries, Italy

27/30

Any site

1976-2010

1,635,060

85,399

This monograph uses data from the AIRTUM Database (at December 2012) regarding all cancer cases, except non-melanoma skin cancer, diagnosed between 1976 and 2010 in the general cancer registries.

MPC coding rules: IARC/IACR rules

1978-1987

1.10 (1.09-1.11)

 

1988-1997

1.08 (1.07-1.10)

1998-2010

1.10 (1.09-1.12)

 Jégu J et al. (2014) [48] 10 French population-based cancer registries, France

28/30

Any site

1989-2004 Followed up to 2007

289,967

21,226

All patients presenting with a first cancer diagnosed between 1989 and 2004, excluding non-melanoma skin cancers.

MPC coding rules: IARC/IACR rules

1989-1994

1.39 (1.36-1.42)

 

1995-1999

1.36 (1.33-1.39)

2000-2004

1.34 (1.30-1.37)

 Youlden DR et al. (2011) [46] Queensland Cancer Registry, Australia

26/30

Any site

1982-2001 Followed up to 2006

204,962

23,580

All patients diagnosed with a first primary invasive cancer between 1982 and 2001 who survived for a minimum of 2 months, restricting to 15 years or older at the time of first diagnosis.

MPC coding rules: Included histologically similar cases of cancer at the same body site. Excluded synchronous primary cancers (those diagnosed within 2 months of the first primary cancer)

1982-1986

1.14 (1.08-1.20)

 

1987-1991

1.22 (1.17-1.28)

1992-1996

1.36 (1.31-1.41)

1997-2001

1.46 (1.41-1.50)

 Sankila R et al. (1995) [52] Finnish Cancer Registry, Finland

22/30

Any site

1953-1991

470,000

19,800

All 470,000 patients registered in Finland from 1953 to 1991 with malignant neoplasms [primary site codes 140–208 in the International Classification of Diseases (ICD-7), WHO, 19571 excluding basal-cell carcinomas of the skin, carcinoma in situ of the uterine cervix, and papilloma of the urinary organs.

MPC coding rules: IARC/IACR rules

1953-1959

1.09 (1.05-1.13)

 

1960-1969

1.11 (1.08-1.14)

1970-1979

1.11 (1.08-1.13)

1980-1991

1.14 (1.11-1.16)

 Tsukuma H et al. (1994) [45] Osaka Cancer Registry, Japan

18/30

Any site

1966-1986 Followed up to 1989

217,307

4,436

All reported cases aged 0–79 who were initially diagnosed with a first primary cancer (invasive cancer and benign intracranial tumour)

MPC coding rules: IARC/IACR rules

 

Ratio of SIRs

 

1966-1971

1.00 (reference)

1972-1977

1.59 (1.33-1.90)

1978-1983

2.89 (2.47-3.38)

1984-1986

2.89 (2.45-3.40)

Specific site

leukaemia, lymphoma and myeloma

 Rebora P et al. (2010) [35] Swedish Cancer Registry, Sweden

23/30

Chronic myeloid leukaemia

1970-1995 Followed up to 2007

2,753

145

All adult cases of CML as a primary diagnosis (ICD-7 code 205.1, age at diagnosis ≥ 18 years) arising between January 1, 1970, and December 31, 1995.

MPC coding rules: not specified.

1970-1984

1.68 (1.32-2.12)

 

1985-1995

1.97 (1.55-2.48)

 Schöllkopf C et al. (2007) [36] Danish Cancer Register, Denmark

24/30

Chronic lymphocytic leukaemia

1943-2003

12,373

1,105

All patients with chronic lymphocytic leukaemia (ICD-7-code 204.0)

MPC coding rules: not specified.

1943- 1994

1.62 (1.50-1.76)

 

Excluding second cancers diagnosed less than one year after CLL

1994- 2003

1.55 (1.41-1.69)

 Hisada M et al. (2007) [40] SEER, U.S.

26/30

Hairy cell leukaemia

1973-2002

3104

358

All hairy cell leukaemia patients who survived for at least 2 months after diagnosis.

MPC coding rules: SEER

1973-1989

1.17 (1.01-1.36)

 

1990-2001

1.30 (1.12-1.51)

 Federico M et al. (2002) [51] The nationwide registry of the Italian Cooperative Group, Italy

22/30

Hairy cell leukaemia

1978-1999

952

49

Patients were recorded in the Italian Registry of HCL between January 1981 and December 1996.

MPC coding rules: not specified.

1978-1982

1.00 (0.27-2.57)

 

1983-1987

0.89 (0.36-1.84)

1988-1992

1.04 (0.62-1.65)

1993-1999

1.02 (0.62-1.58)

 M.P. Coleman et al. (1987) [32] South Thames (now Thames) Cancer Registry, UK

28/30

Hodgkin’s disease

1961-1980 Followed up to 1981

2,970

58

All patients registered with Hodgkin’s disease in the South Thames Cancer Registry during the period 1961–80.

Excluded patients if they had had another tumour registered either before or at the same time as the index tumour, or if their index tumour had been registered at death (no follow-up) or at age 85 years or more.

Second cancer defined as the site and the histology are distinct from the first. Second cancers at the same site as the first or at a different site but with the same histology as the first will be registered only if the hospital record or pathology report explicitly states that it is a new primary, distinct from the previous cancer.

Excluded second tumours occurring at age 85 or over.

1961-1969

1.2

 

1970-1980

1.6

 Lorenzo Bermejo J et al. (2014) [34] Cancer registries of Finland, Norway and Sweden

22/30

non-Hodgkin lymphoma

1980-2006

21,036 Finnish,

6815

Almost all histologically confirmed cases of non-Hodgkin lymphoma.

MPC coding rules: not specified

1980-84

 

0.65 (0.59-0.72)

1985-89

0.71 (0.66-0.77)

14,027 Norwegian

 

1990-94

0.77 (0.72-0.83)

1995-99

0.77 (0.73-0.82)

25,838 Swedish

 

2000-06

Reference

 Rossi C et al. (2015) [54] 10 French population-based cancer registries, France

25/30

non-Hodgkin lymphoma

1989-2004 Followed up to 2007

7,546

580

NHL patients was extracted from the K2 France cohort, which includes cancer cases diagnosed between 1989 and 2004 recorded by 10 French populationbased cancer registries. Patients who developed a synchronous second cancer (<61 days of follow-up) were excluded.

MPC coding rules: A Second Primry Cancer was defined as the first subsequent primary cancer occurring at least two months (≥61 days) after the first diagnosis of NHL.

 

Ratio of SIRs

 

1989-1994

1.00 (reference)

1995-1999

1.07 (0.86-1.34)

2000-2004

1.37 (1.08-1.74)

 Razavi P et al. (2013) [43] SEER, U.S.

28/30

Multiple myeloma

1973-2008

36,491

2021

All cases were identified by site code ICD-0-3: C9732 and C9734.

Excluded cases whose reporting sources were coded as autopsy or death-certificate-only (n = 775), cases where MM was not the first primary (n = 3545) and cases with second cancer diagnosed within the first 2 months of MM diagnosis (n = 365)

MPC coding rules: SEER

1973-1984

1.04 (0.95-1.13)

 

1985-1999

0.95 (0.90-1.02)

All second cancers except cancers within the first two months after diagnosis of MM

2000-2008

0.96 (0.88-1.06)

Breast and ovarian cancer

 Mellemkjaer L et al. (2006) [37] 13 population-based cancer registries Europe, Australia, Canada and Singapore

26/30

Breast cancer

1943-2000

525,527

31,399

All women with a first primary breast cancer (ICD-9 5 174) except patients for whom the first primary cancer diagnosis and death were recorded at the same time or who had 2 first primary cancers recorded simultaneously (same dates of diagnosis).

MPC coding rules: IARC/IACR

<1975

1.32 (1.30-1.35)

 

1975-1983

1.22 (1.20-1.25)

Second cancers except contralateral breast cancer, brain and nervous system only included malignant tumours, bladder cancer included papilloma, included all non-melanoma skin cancer

1984-1990

1.23 (1.20-1.26)

1991+

1.18 (1.14-1.22)

 Brown LM et al. (2007) [31] Population-based cancer registries in Denmark, Finland, Norway and Sweden

27/30

Breast cancer

1943-2002

376,825

23,158

All women diagnosed with a first primary cancer of the breast between January 1, 1943 and December 31, 2002 who survived at least 1 year.

MPC coding rules: Subsequent primary non-haematological malignancies (except breast cancer) that developed at least 1 year after breast cancer diagnosis

<1980

1.19a

 

≥1980

1.09a

a Confidence interval does not include 1.0

 Molina-Montes E et al. (2013) [38] Granada Cancer Registry, Spain

26/30

Breast cancer

1985-2007

5897

314

All cases were identified by site code ICD-O-3 (C50).

MPC coding rules: IACR/IARC

1985-1995

1.37 (1.16-1.58)

 

Exclude patients whose first primary cancer diagnosis and death were recorded simultaneously and synchronous first primary cancers.

All second primary cancers except contralateral breast cancer which considered as a single tumour.

1996-2007

1.41 (1.18-1.64)

 M.P. Coleman et al. (1987) [32] South Thames (now Thames) Cancer Registry, UK

28/30

Ovarian cancer

1961-1980 Followed up to 1981

11,802

170

All patients registered with cancer of the ovary in the South Thames Cancer Registry during the period 1961–80.

Excluded patients if they had had another tumour registered either before or at the same time as the index tumour, or if their index tumour had been registered at death (no follow-up) or at age 85 years or more.

Second cancer defined as the site and the histology are distinct from the first. Second cancers at the same site as the first or at a different site but with the same histology as the first will be registered only if the hospital record or pathology report explicitly states that it is a new primary, distinct from the previous cancer.

Excluded second tumours occurring at age 85 or over.

1961-1969

1.1

 

1970-1980

1.2

Thyroid cancer

 Cho YY et al. (2015) [49] Korean Central Cancer Registry, Korea

25/30

Thyroid cancer

1993-2010

178,844

2,895

Records code C73.9 starting in January 1993 through

December 2010. Patients who developed a second malignancy within the first 2 months of follow-up (n = 628) were excluded.

MPC coding rules: not specified.

1993-1997

0.98 (0.90-1.07)

 

1998-2002

1.05 (0.98-1.13)

2003-2007

1.09 (1.03-1.15)

2008-2010

1.06 (0.96-1.17)

 Kim C et al. (2013) [42] SEER, U.S.

24/30

Thyroid cancer

1973-2008

52,103

4457

All cases were identified by site code ICD-0-3: C739, reported to a SEER 9 database

between 1973-2008

MPC coding rules: SEER

All second cancers

except cancers within the first two months after initial thyroid cancer

1973-1983

1.02 (0.97-1.07)

 

1984-1993

1.03 (0.97-1.08)

1994-2003

1.21 (1.14-1.28)

2004-2008

1.45 (1.28-1.62)

Prostate cancer

 Joung JY et al. (2015) [55] Korean Central Cancer Registry, Korea

22/30

Prostate cancer

1993-2011

55,378

2,578

Patients diagnosed with a first prostate cancer between 1993 and 2011. Excluded patients who presented with a SPC within two months of their first prostate cancer diagnosis, patients with subsequent prostate cancer after the diagnosis of another primary cancer, and patients for whom only death certificate information was available.

MPC coding rules: not specified

1993-2000

0.6

 

2001-2011

0.7

 Levi F et al. (1999) [33] Vaud and Neuchâtel Cancer Registry, Switzerland

26/30

Prostate carcinoma

1974-1994

4,503

380

Cases of first diagnosed prostate carcinoma registered between 1974 and 1994 with histologic confirmation available for 89.7 %.

MPC coding rules: not specified

1974-1984

0.7 (0.6-0.8)

 

1985-1994

0.7 (0.6-0.8)

Other sites (malignant meningioma, head and neck, oesophageal, ocular melanoma, merkel cell, colorectal cancer, bladder, testis)

 Bao X et al. (2014) [39] SEER, U.S.

26/30

Malignant meningioma

1973-2007

1,603

56

All patients in the SEER database with the diagnosis of malignant meningioma were identified via SEER program 6.6.2 (1973–2007).

MPC coding rules: SEER

1973-1988

0.78

 

1989-1999

1.01

2000-2007

0.56

 Jégu J et al. (2013) [50] Bas-Rhin populationbased cancer registry, France

28/30

Head and neck squamous cell carcinomas

1975-2006

7,329

1,326

All patients were followed-up for 10 years or until December 31, 2006. HNSCC included here were squamouscell carcinomas (ICD-O-3 histology codes 8070–8076, 8078) localized at the oral cavity, oropharynx, hypopharynx and larynx (ICD-O-3 site codes C01–C06, C09–C10, C12–C13, C32).

MPC coding rules: IARC/IACR rules

 

Ratio of SIRs

 

1975-1979

1.00 (reference)

1980-1984

1.15 (0.95-1.40)

1985-1989

1.29 (1.06-1.55)

1990-1994

1.25 (1.03-1.51)

1995-1999

1.10 (0.90-1.35)

2000-2006

0.85 (0.67-1.08)

 Zhu G et al. (2012) [44] SEER, U.S.

25/30

Oesophageal cancer

1973-2007

24,557

985

All oesophageal cancer patients who survived for at least 2 months after diagnosis.

MPC coding rules: SEER

All second primary cancers except non-melanoma skin cancers

1973-1989

1.43 (1.29-1.58)

 

1990-2007

1.28 (1.18-1.38)

 Scélo G et al. (2007) [47] 13 population-based cancer registries Europe, Australia, Canada and Singapore

25/30

Ocular melanoma

1943-2000

10,396

1,029

All cases of ocular melanoma without stratifying by subsite.

MPC coding rules: IARC/IACR rules

<1975

1.17 (1.06-1.29)

 

1975-1983

1.21 (1.08-1.35)

1984-1990

1.39 (1.20-1.59)

1991+

1.33 (1.08-1.62)

 Howard RA et al. (2006) [41] SEER, U.S.

26/30

Merkel cell carcinoma

1986-2002

1,306

122

All patients with a first primary cutaneous MCC in 1 of 11 population-based cancer registries of SEER program (1986–2002).

MPC coding rules: SEER

Subsequent primary cancers were invasive primary neoplasms that developed at least 1 month after a diagnosis of MCC. Excluded secondary MCC following primary MCC.

1986-1994

1.09 (0.83-1.40)

 

1995-2002

1.37 (1.05-1.76)

 Guan X et al. (2015) [53] SEER, U.S.

23/30

Colorectal cancer

1992-2012

240,584

27,731

Invasive CRC patients who were diagnosed

MPC coding rules: SEER

Colon

  

1992-2001

1.08

at the age of more than 20 years. Excluded patients: 1) diagnosed with unknown age, 2) reported only on death or autopsy certificate only, 3) being stage of in situ. SPMs diagnosed during six months period after the primary diagnosis were also excluded.

 

2002-2012

1.25

Rectum

 

1992-2001

1.00

2002-2012

1.16

 Muller J et al. (2015) [56] 10 French population-based cancer registries, France

28/30

Bladder cancer

1989-2004 Followed up to 2007

10,047

1,291

All patients with a first bladder cancer (BCa) diagnosed between 1989 and 2004 and followed up to 31 December 2007. Excluded patients with a known history of previous cancer before BCa diagnosis

MPC coding rules: IARC/IACR rules

1989-1992

1.53 (1.37-1.71)

 

1993-1996

1.42 (1.27-1.58)

1997-2000

1.57 (1.41-1.74)

2001-2004

2.02 (1.79-2.27)

 M.P. Coleman et al. (1987) [32] South Thames (now Thames) Cancer Registry, UK

28/30

Testicular cancer

1961-1980 Followed up to 1981

2,013

27

All patients registered with cancer of the testis in the South Thames Cancer Registry during the period 1961–80.

Excluded patients if they had had another tumour registered either before or at the same time as the index tumour, or if their index tumour had been registered at death (no follow-up) or at age 85 years or more.

Second cancer defined as the site and the histology are distinct from the first. Second cancers at the same site as the first or at a different site but with the same histology as the first will be registered only if the hospital record or pathology report explicitly states that it is a new primary, distinct from the previous cancer.

Excluded second tumours occurring at age 85 or over.

1961-1969

0.8

 

1970-1980

0.7

  1. STROBE Strengthening the Reporting of Observational Studies in Epidemiology, MPCs multiple primary cancers, N number of patients, SEER Surveillance, Epidemiology, and End Results, IARC/IACR International Association of Cancer Registries (IACR)/the International Agency for Research on Cancer (IARC), CI confidence interval, ICD International Classification of Diseases, CML chronic myeloid leukaemia, CLL chronic lymphocytic leukaemia, MM multiple myeloma, MCC Merkel cell carcinoma