Ann Hepatobiliary Pancreat Surg.  2023 Nov;27(4):415-422. 10.14701/ahbps.23-053.

Exocrine pancreatic cancer as a second primary malignancy: A population-based study

• Kang MJ
• Lim J
• Han SS
• Park HM
• Cho SC
• Park SJ
• Kim SW
• Won YJ

• KMID: 2548508
• DOI: http://doi.org/10.14701/ahbps.23-053

Abstract

Backgrounds/Aims
Although cancer survivors are at higher risk of developing second primary malignancies, cancer surveillance strategies for them have not yet been established. This study aimed to identify first primary cancers that had high risks of developing second primary exocrine pancreatic cancer (EPC).
Methods
Data on individuals diagnosed with primary cancers between 1993 and 2017 were obtained from the Korea Central Cancer Registry. The standardized incidence ratios (SIRs) of second primary EPCs were analyzed according to the primary tumor sites and follow-up periods.
Results
Among the 3,205,840 eligible individuals, 4,836 (0.15%) had second primary EPCs, which accounted for 5.8% of the total EPC patients in Korea. Between 1 and 5 years after the diagnosis of first primary cancers, SIRs of second primary EPCs were increased in patients whose first primary cancers were in the bile duct (males 2.99; females 5.03) in both sexes, and in the small intestine (3.43), gallbladder (3.21), and breast (1.26) in females. Among those who survived 5 or more years after the diagnosis of first primary cancers, SIRs of second primary EPCs were elevated in patients whose first primary cancers were in the bile duct (males 2.61; females 2.33), gallbladder (males 2.29; females 2.22), and kidney (males 1.39; females 1.73) in both sexes, and ovary (1.66) and breast (1.38) in females.
Conclusions
Survivors of first primary bile duct, gallbladder, kidney, ovary, and female breast cancer should be closely monitored for the occurrence of second primary EPCs, even after 5 years of follow-up.

Keyword

Second primary neoplasm; Incidence; Pancreatic neoplasms; Bile duct neoplasms; Gallbladder neoplasms

Figure

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  Fig. 1 Distribution of age group at diagnosis of first primary and subsequent cancer. EPC, exocrine pancreatic cancer.

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  Fig. 2 Observed cases and statistically significant SIRs of secondary exocrine pancreatic cancer by sex and follow-up period. (A) Summary. (B) Male. (C) Female. SIR, standardized incidence ratio.

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