Multiple primary tumours following head and neck cancer in southern England during 1961–98

Abstracts on this page have been chosen and edited by Dr Trevor Watts

Abstract

In tobacco-associated sites, there was a significant risk of further primary tumours.

Main

Warnakulasuriya KAAS, Robinson D et al. J Oral Pathol Med 2003; 32: 443–449

In western countries, as many as 20% of patients with head and neck tumours may develop second primaries. This study examined data from a database on cancer relating to 14 million people in south-east England. Over the observation period, 38,970 head and neck tumours were reported in men, and 20,988 in women. Over a mean follow-up time of 3.4 years, 2138 men developed 1 to 4 further primary tumours at any body site, and over a mean 3.1 years, 752 women developed 1 to 3.

For 'tobacco sites' — tongue, salivary glands, mouth, oropharynx, nasopharynx, oesophagus, larynx, lung, bronchus and bladder — the standardized incidence ratio of second primary tumours was 1.14, significantly higher than expected. For all other sites, it was significantly lower at 0.87. However, there was no excess risk for myeloid leukaemia, indicating little effect of radiotherapy in comparison with smoking. The authors discuss these and other factors which might explain the results.