Risk of second malignant neoplasms in patients diagnosed with head and neck cancer between 1994-2014 in Girona, Spain: a population-based study

Introduction: Head and Neck Cancer (HNC) is a highly heterogeneous disease comprising a large number of tumours located in the cervicofacial area. Risk factors implicated in this pathology are known, and many of them are associated with the risk to develop a second malignant neoplasm (SMN). This fact besides of the increase of 5- years surveillance of those patients, may promote the increment of risk of having a SMN. Data/Methods: 2748 cases of HNC (lips, oral cavity, salivary glands, oropharyngeal, nasopharyngeal, hypopharyngeal, nose, ear and sinuses and laryngeal cancers) were identified in the Girona Cancer Registry (GCR) database during the period 1994-2014. 420 cases of SMN were identified in those patients (390 in men and 30 in women). These patients were analysed to evaluate which of them developed a second malignant neoplasm (SMN), where was the new cancer located and to estimate the risk of suffering a new neoplasm in comparison with general population by the calculation of the standardized incidence ratio (SIR) and the excessive absolute risk (EAR). Results: Our study confirms the higher risk of a SMN in patients with a previous HNC, which was increased at all sublocations of the head and neck except primary tumours located at nasopharynx. Our male sample presented a SIR 3.25 (2.94 - 3.59) and an EAR 280.13 (240.97 - 322.38) while female population presented a SIR of 3.52 (2.37 - 5.02) and an EAR of 112.22 (61.12 -179.51). The risk of a SMN at any head and neck sites was incremented in patients with a previous cancer at oral cavity, salivary glands, oropharynx and larynx. Conclusions: Our investigation verifies the higher risk of a SMN in patients with a previous HNC in our population. These results were similar after comparing our population with the Italian (AIRTUM), USA (SEER) and French (Jegú et al.), with a similar tendency ​
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