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Oral Dis. 2019 May;25(4):1067-1075. doi: 10.1111/odi.13080. Epub 2019 Mar 27.

Risk for a second primary hypopharyngeal and esophageal cancer after an initial primary oral cancer.

Author information

1
Division of Otorhinolaryngology- Head & Neck Surgery, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan.
2
School of Medicine, Tzu Chi University, Hualien, Taiwan.
3
Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan.
4
School of Oral Hygiene, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan.
5
Department and Graduate Institute of Health Care Management, Kainan University, Tao-Yuan, Taiwan.
6
Department of Health Care Management and Healthy Aging Research Center, Chang Gung University, Tao-Yuan, Taiwan.
7
Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.
8
Department of Internal Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan.
9
Big Data Research Center, Changhua Christian Hospital, Changhua, Taiwan.
10
Department of Otolaryngology- Head & Neck Surgery, Changhua Christian Hospital, Changhua, Taiwan.
11
Innovation and Policy Center for Population Health and Sustainable Environment, College of Public Health, National Taiwan University, Taipei, Taiwan.
12
Department of Otolaryngology, College of Medicine, National Taiwan University, Taipei, Taiwan.

Abstract

OBJECTIVE:

To investigate the risk for second primary cancer in the hypopharynx and esophagus (SPC-HE) among individuals with an initial oral/oropharyngeal cancer.

MATERIALS AND METHODS:

Mass screening data from Taiwan (2004-2009) included individuals who were ≥18 years old and smoked cigarettes and/or chewed betel quid. Occurrence of SPC-HE was monitored until December 31, 2014. Results were expressed as adjusted relative risk (aRR) and 95% confidence interval (CI).

RESULTS:

One hundred and fifty-eight out of 4,494 subjects with oral cancer developed SPC-HE (incidence rate: 6.47 per 1,000 person-years). Relative to patients with primary cancers in the lip, the risk of an SPC-HE was higher in patients with primary cancers in oropharynx (aRR: 19.98, 95% CI: 4.72-84.55), floor of mouth (aRR: 12.13, 95% CI: 2.67-55.15), and hard palate (aRR: 7.31, 95% CI: 1.65-32.37), but not in patients with cancers in tongue (aRR: 3.67, 95% CI: 0.89-15.17) or gum (aRR: 3.99, 95% CI: 0.92-17.35). Regression analyses also showed the risk of an SPC-HE was greater in alcohol drinkers than those who did not (aRR: 1.65, 95% CI: 1.10-2.48).

CONCLUSIONS:

Compared with the initial cancer in the lip, patients with a cancer in the oropharynx, floor of mouth, and hard palate had a higher risk for the SPC-HE.

KEYWORDS:

cancer screening; esophageal cancer; hypopharyngeal cancer; oral/oropharyngeal cancer; second primary cancer

PMID:
30821883
DOI:
10.1111/odi.13080

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