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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