Cervical cancer survivors at increased risk of subsequent tobacco-related malignancies, United States 1992–2008
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Persistent smoking among cancer survivors may increase their risk of subsequent malignancies, including tobacco-related malignancies. Despite these risks, nearly 40 % of women diagnosed with cervical cancer continue to smoke after diagnosis. This study describes the relative risk of developing any subsequent and tobacco-related malignancy among cervical cancer survivors.
We examined data from the year 1992 to 2008 in 13 Surveillance, Epidemiology and End Results registries. We calculated the standardized incidence ratio (SIR) and 95 % confidence limits (CLs) for all subsequent and tobacco-related malignancies among cervical cancer survivors. Tobacco-related malignancies were defined according to the 2004 Surgeon General’s Report on the Health Consequences of Smoking. For comparison with cervical cancer survivors, SIRs for subsequent malignancies were also calculated for female survivors of breast or colorectal cancers.
The SIR of developing a subsequent tobacco-related malignancy was higher among cervical cancer survivors (SIR = 2.2, 95 % CL = 2.0–2.4). Female breast (SIR = 1.1, 95 % CL = 1.0–1.1) and colorectal cancer survivors (1.1, 1.1–1.2) also had an elevated risk. The increased risk of a subsequent tobacco-related malignancy among cervical cancer survivors was greatest in the first 5 years after the initial diagnosis and decreased as time since diagnosis elapsed.
Women with cervical cancer have a two-fold increased risk of subsequent tobacco-related malignancies, compared with breast and colorectal cancer survivors. In an effort to decrease their risk of subsequent tobacco-related malignancies, cancer survivors should be targeted for tobacco prevention and cessation services. Special attention should be given to cervical cancer survivors whose risk is almost twice that of breast or colorectal cancer survivors.
KeywordsSecond primary neoplasms Uterine cervical neoplasms Epidemiology Tobacco
- 1.Centers for Disease Control and Prevention (2011) Cancer survivors—United States, 2007. MMWR 60:269–272Google Scholar
- 2.Ries LAG, Melbert D, Krapcho M et al (2007) SEER cancer statistics review, 1975–2004. National Cancer Institute, Bethesda, MD. Year. Available at URL: http://seer.cancer.gov/csr/1975_2004/ based on November 2006 SEER data submission, posted to the SEER website, 2007. Published in 2007
- 4.Kleinerman RA, Kosary C, Hildesheim A (2006) New malignancies following cancer of the cervix uteri, vagina, and vulva. In: New malignancies among cancer survivors: SEER cancer registries, 1973–2000. NIH Publ. No. 05-5302. National Cancer Institute, Bethesda, MD, pp 207–229Google Scholar
- 11.Centers for Disease Control and Prevention (CDC), Vital Signs. Smoking and Tobacco Use. Atlanta, GA. http://www.cdc.gov/tobacco/data_statistics/vital_signs/index.htm. Accessed August, 29 2011
- 12.The 2004 United States Surgeon General’s Report: The Health Consequences of Smoking (2004) N S W Public Health Bull 15(5–6):107Google Scholar
- 13.Botteri E, Iodice S, Bagnardi V, Raimondi S, Lowenfels AB, Maisonneuve P (2008) Smoking and colorectal cancer. J Am Med Assoc 300(23):2765Google Scholar
- 16.Curtis RE, Freedman DM, Ron E, Ries LAG, Hacker DG, Edwards BK, Tucker MA, Fraumeni JF Jr (eds) (2006). New malignancies among cancer survivors: SEER cancer registries, 1973–2000. National Cancer Institute, NIH Publ. No. 05-5302, Bethesda, MDGoogle Scholar
- 17.Johnson CH (Ed) (2004) SPCaSM, revision 1. National Cancer Institute, NIH Publ. No. 04-5581, Bethesda, MDGoogle Scholar
- 24.HPV Associated Cancers. Centers for Disease Control and Prevention A, GA. Available at: http://www.cdc.gov/cancer/hpv/basic_info/
- 25.Castle PE (2008) How does tobacco smoke contribute to cervical carcinogenesis? J Virol 82(12):6084–6085; author reply 6085–6086Google Scholar
- 29.Hewitt M, Greenfield S, Stovall E (Eds) (2006) From cancer patient to cancer survivor: lost in transition. Committee on cancer survivorship: improving care and quality of life. National Academies Press, Washington, DCGoogle Scholar
- 30.Centers for Disease Control and Prevention (2004) A national action plan for cancer survivorship: advancing public health strategies. US Department of Health and Human Services, Atlanta, GAGoogle Scholar
- 31.National Institutes of Health (NIH) (2011) NCI, surveillance epidemiology and end results (SEER). SEER Stat Fact Sheets: Cervix Uteri. Bethesda: NCI, 2011. Accessed http://www.seer.cancer.gov/statfacts/html/cervix.html. Accessed May 30 2011
- 33.Wingo PA, Jamison PM, Hiatt RA et al (2003) Building the infrastructure for nationwide cancer surveillance and control–a comparison between the National Program of Cancer Registries (NPCR) and the Surveillance, Epidemiology, and End Results (SEER) Program (United States). Cancer Causes Control 14(2):175–193PubMedCrossRefGoogle Scholar
- 34.Boice J Jr, Land C, Preston D (1996) Ionizing radiation: cancer epidemiology and prevention. Oxford University Press, New YorkGoogle Scholar
- 38.SEER Cancer Stat Fact Sheets. National Cancer Institute. Available at: http://seer.cancer.gov/statfacts/