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Variation in patterns of second primary malignancies across U.S. race and ethnicity groups: a Surveillance, Epidemiology, and End Results (SEER) analysis

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Abstract

Purpose

One in six incident cancers in the U.S. is a second primary cancer (SPC). Although primary cancers vary considerably by race and ethnicity, little is known about the population-based occurrence of SPC across these groups.

Methods

Using Surveillance, Epidemiology, and End Results (SEER) 12 data and relative to the general population, we calculated standardized incidence ratios (SIRs) and 95% confidence intervals (CIs) for SPC among 2,457,756 Hispanics, non-Hispanic Asian American/Pacific Islanders (NHAAPI), non-Hispanic black (NHB), and non-Hispanic whites (NHW) cancer survivors aged 45 years or older when diagnosed with a first primary cancer (FPC) from 1992 to 2015.

Results

The risk of second primary bladder cancer after first primary prostate cancer was higher than expected in Hispanic (SIR = 1.18, 95% CI: 1.01–1.38) and NHAAPI (SIR = 1.41, 95% CI: 1.20–1.65) men than NHB and NHW men. Among women with a primary breast cancer, Hispanic, NHAAPI, and NHB women had a nearly 1.5-fold higher risk of a second primary breast cancer, while NHW women had a 6% lower risk. Among men with prostate cancer whose SPC was diagnosed 2 to <12 months, NHB men were at higher risk for colorectal cancer and Hispanic and NHW men for non-Hodgkin’s lymphoma. In the same time frame for breast cancer survivors, Hispanic and NHAAPI women were significantly more likely than NHB and NHW women to be diagnosed with a second primary lung cancer.

Conclusion

Future studies of SPC should investigate the role of shared etiologies, stage of diagnosis, treatment, and lifestyle factors after cancer survival across different racial and ethnic populations.

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Data availability

Access to SEER*Stat databases is available through here: https://seer.cancer.gov/data/access.html

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Funding

This research was supported by the National Cancer Institute’s Surveillance, Epidemiology and End Results Program under contract HHSN261201800032I awarded to the University of California, San Francisco. The collection of cancer incidence data used in this study was supported by the California Department of Public Health pursuant to California Health and Safety Code Section 103885; Centers for Disease Control and Prevention’s (CDC) National Program of Cancer Registries, under cooperative agreement 1NU58DP007156; the National Cancer Institute’s Surveillance, Epidemiology and End Results Program under contract HHSN261201800032I awarded to the University of California, San Francisco, contract HHSN261201800015I awarded to the University of Southern California, and contract HHSN261201800009I awarded to the Public Health Institute, Cancer Registry of Greater California. The ideas and opinions expressed herein are those of the author(s) and do not necessarily reflect the opinions of the State of California, Department of Public Health, the National Cancer Institute, and the Centers for Disease Control and Prevention or their Contractors and Subcontractors.

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Authors and Affiliations

  1. Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, 94158-2549, USA

    Valerie McGuire, Daphne Y. Lichtensztajn, Juan Yang & Iona Cheng

  2. Greater Bay Area Cancer Registry, Cancer Prevention Institute of California, Fremont, CA, USA

    Daphne Y. Lichtensztajn, Li Tao, Juan Yang, Christina A. Clarke, Sally L. Glaser & Iona Cheng

  3. Department of Population and Public Health Science, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA

    Anna H. Wu

  4. Epidemiology Program, University of Hawaii at Manoa, Honolulu, HI, USA

    Lynne Wilkens & Sungshim Lani Park

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  1. Valerie McGuire
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Contributions

SLP and IC designed the study and directed its execution, including quality assurance and control. VM conducted the literature review and wrote the first draft of the manuscript. All authors commented on previous versions of the manuscript and approved the final manuscript. SLP, IC, DYL, and LT designed the study’s analytic strategy. DYL performed statistical analyses.

Corresponding author

Correspondence to Valerie McGuire.

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The authors declare no potential conflicts of interest.

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The study was approved by UCSF Institutional Review Board.

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McGuire, V., Lichtensztajn, D.Y., Tao, L. et al. Variation in patterns of second primary malignancies across U.S. race and ethnicity groups: a Surveillance, Epidemiology, and End Results (SEER) analysis. Cancer Causes Control 35, 799–815 (2024). https://doi.org/10.1007/s10552-023-01836-2

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