Women diagnosed with cervical cancer tend to have good long-term survival, but they often have specific risk factors for developing a cancer later in life: a history of smoking, infection with the human papillomavirus, and/or treatment with radiation therapy.
A study by researchers in the U.S., Denmark, Finland, Sweden, and Norway has documented cervical cancer survivors' significantly increased risk of developing a second primary cancer--a risk that lasts for several decades after their initial diagnosis of invasive cervical cancer. Using 13 population-based cancer registries in Denmark, Finland, Sweden, Norway, as well as the U.S. Surveillance, Epidemiology, and End Results program, the researchers studied 104,760 cervical cancer survivors starting one year after their diagnosis and continuing over the next 40 years or more. They found that these women had a 30 percent higher incidence of all second cancers compared to women in the general population.
"The unique aspect of this study is the long length of follow up," said Anil Chaturvedi, Ph.D., MPH, a researcher at the Division of Cancer Epidemiology and Genetics, National Cancer Institute. "Previous studies had evaluated second cancer risk up to 30 years of follow up. With these registries, we were able to assess longer-term risk over 40 years or more."
The researchers examined the women's risk for specific cancers associated with smoking and HPV infection -- known causes of cervical cancer. "We did not have information on smoking in our study, but it has been well-documented that women with cervical cancer are more likely to have a history of smoking," Chaturvedi said.
Compared to women in the general population, risks for HPV-related cancers (oropharynx, female genital sites, and anus) and smoking-related cancers (lung, pancreas, and urinary bladder) were significantly elevated.
The researchers also compared second cancer risk in women who had radiation treatment versus women in the general population. Women who underwent radiation were at increased risk for any second cancer and cancers at heavily irradiated sites (colon, rectum/anus, urinary bladder, ovary, female genital sites) beyond 40 years of follow up.
"What's most significant is that even as far out as 40 years after diagnosis, these women have an increased risk for second cancers," Chaturvedi said. "These results suggest a need for close medical surveillance for second cancers."
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