Las mujeres que sobreviven al cáncer de cuello uterino tienen mayor riesgo de sufrir otros cánceres

Las mujeres que sobreviven a un cáncer de cuello uterino tienen mayor riesgo de sufrir otros cánceres, según una publicación del Journal of the National Cancer Institute. El aumento de riesgo se produce sobre todo en mujeres irradiadas en los órganos pélvicos que están cerca del cérvix.

Los estudios previos indicaban que el riesgo de un segundo cáncer estaba aumentado, pero no estaba claramente definido dónde se producían los nuevos tumores.Los nuevos resultados se basan en 104,760 mujeres escandinavas y norteamericanas supervivientes en las que se calcularon las tasas de segundo cáncer a lo largo de más de 40 años. La tasa de infección por virus del papiloma y cánceres relacionados con fumar estaban aumentadas en las irradiadas y en las no irradiadas.

J Natl Cancer Inst. 2007 Oct 30; Second Cancers Among 104760 Survivors of Cervical Cancer: Evaluation of Long-Term Risk.

Chaturvedi AK, Engels EA, Gilbert ES, Chen BE, Storm H, Lynch CF, Hall P, Langmark F, Pukkala E, Kaijser M, Andersson M, Fosså SD, Joensuu H, Boice JD, Kleinerman RA, Travis LB.

International Epidemiology Institute, Rockville, MD (JDB); Vanderbilt-Ingram Cancer Center, Nashville, TN (JDB); Exponent Inc, New York, NY (LBT).

Background Given the extended survival of patients diagnosed with cervical cancer, the large number of these women treated with radiotherapy, and the presence in this population of established cancer risk factors such as human papillomavirus (HPV) infection and cigarette smoking, it is important to clarify long-term trends in second cancer risk. Methods Using data from 104760 one-year survivors of cervical cancer reported to 13 population-based cancer registries in Denmark, Finland, Norway, Sweden, and the United States, we calculated standardized incidence ratios (SIRs) for second cancers overall and cancers at particular sites among women with cervical cancer, including cervical cancer patients who were treated or not treated with radiation, over more than 40 years of follow-up. Cox regression models were used to assess the time-varying association of radiotherapy with risk of second cancers and to assess the interaction of radiation treatment with age at diagnosis. All statistical tests were two-sided. Results Among 104760 one-year survivors of cervical cancer, the risk of all second cancers taken together was increased to a statistically significant extent (n = 12496; SIR = 1.30; 95% confidence interval [CI] = 1.28 to 1.33). Compared with the general population, in both radiotherapy (N = 52613) and no-radiotherapy groups (N = 27382), risks for HPV-related cancers (of the pharynx, genital sites, and rectum/anus) and smoking-related cancers (of the pharynx, trachea/bronchus/lung, pancreas, and urinary bladder) were elevated to a statistically significant extent. Cervical cancer patients treated with radiotherapy, but not those who did not receive radiotherapy, were at increased risk for all second cancers and cancers at heavily irradiated sites (colon, rectum/anus, urinary bladder, ovary, and genital sites) beyond 40 years of follow-up compared with women in the general population. The association of radiotherapy with second cancer risk was modified by age at cervical cancer diagnosis for rectum/anus, genital sites, and urinary bladder, with higher hazard ratios for second cancer at younger ages of cervical cancer. After adjustment for competing mortality, the 40-year cumulative risk of any second cancer was higher among women diagnosed with cervical cancer before age 50 (22.2%; 95% CI = 21.5% to 22.8%) than among women diagnosed after age 50 (16.4%; 95% CI = 16.1% to 16.9%). Conclusion Cervical cancer patients treated with radiotherapy are at increased risk of second cancers at sites in close proximity to the cervix beyond 40 years of follow-up.

servido por gineblog sin comentarios compártelo