Second primary malignancies in patients with non-melanoma skin cancer: Results from a cancer registry–based study in Emilia Romagna, north-east Italy

• Published in: Cancer epidemiology 2019-08, Vol.61, p.176-184
• Main Authors: Borghi, Alessandro, Corazza, Monica, Chiaranda, Giorgio, Michiara, Maria, Mangone, Lucia, Caruso, Bianca, Falcini, Fabio, Maestri, Iva, Ferretti, Stefano
• Format: Article
• Language: English
• Subjects: Cancer; Cancer registry; Cancer survivors; Cancer therapies; Cohort Studies; Epidemiology; Excess absolute risk; Female; Health risk assessment; Health risks; Humans; Incidence; Italy - epidemiology; Leukemia; Lymphoma; Male; Melanoma; Neoplasms, Second Primary - epidemiology; Neoplasms, Second Primary - etiology; Non-melanoma skin cancers; Patients; Population; Population genetics; Prostate; Registries; Retrospective Studies; Risk analysis; Risk Factors; Skin cancer; Skin Neoplasms - epidemiology; Skin Neoplasms - mortality; Standardized incidence ratio; Studies; Subsequent primary malignancies; Survival Rate; Tumors
• ISSN: 1877-7821; 1877-783X
• DOI: 10.1016/j.canep.2019.06.010

•Subjects with non-melanoma skin cancers have an increased risk of developing second primary cancers in comparison with the general population.•For some tumors this higher relative risk also results in an effective increase in cancer occurrence when compared to those expected.•Both intrinsic and environmental risk factors seem to concur on the increased occurrence of multiple tumors in non-melanoma skin cancer patients. previous research on the risk of subsequent, primary non-cutaneous malignancies among patients with non-melanoma skin cancers (NMSCs) led to conflicting results. We aimed to investigate a possible link between NMSC and second primary malignancies by using the population-based data available in cancer registries. this observational study retrospectively assessed the risk of occurrence of both synchronous and methachronous second primary tumours in a cohort of cancer patients whose first diagnosis was NMSC. The cohort came from the network of general cancer registries of the Emilia-Romagna Region, northeast Italy, in the period between 1978 and 2012, and was compared with the general population living in the same area. Two main indexes were used: i) Standardized Incidence Ratio (SIR), calculated as the ratio between the observed and the expected number of second cancers and ii) Excess Absolute Risk (EAR), expressing the absolute excess or deficit of second cancer incidence. in the period analysed (1978–2012, 72,503,157 person/years, PYs), 89,912 primary NMSC were found in 76,414 patients. Among them, 14,195 developed a second primary cancer in the subsequent 501,763 follow-up PYs. NMSC patients showed an overall SIR of 1.22 (CI 95% 1.20-1,24) and an EAR of 5.11 cases/1000 PYs (CI 95% 4.48–5.74). the study results showed that NMSC patients had an increase in relative risk and, at least for some tumours, in absolute risk of developing a second cancer when compared with the general population. Genetic, environmental and personal risk factors may influence this finding.