This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Travis, L. B. Articles by Fraumeni, J. F. Search for Related Content PubMed PubMed Citation Articles by Travis, L. B. Articles by Fraumeni, J. F., Jr.

Second Malignant Neoplasms among Long-Term Survivors of Ovarian Cancer

Division of Cancer Epidemiology and Genetics [L. B. T., R. E. C., J. D. B., J. F. F.], and Cancer Statistics Branch, Surveillance Program, Division of Cancer Prevention and Control [B. F. H.], National Cancer Institute, National Institutes of Health, Bethesda, Maryland 20892; and Department of Pathology, University of Iowa, Iowa City, Iowa [C. E. P.]

Second malignant neoplasms were evaluated among 32,251 women with ovarian cancer, including 4,402 10-year survivors, within the nine population-based registries of the Surveillance, Epidemiology, and End Results Program of the National Cancer Institute (1973–1992) and the Connecticut Tumor Registry (1935–1972). Overall, 1,296 second cancers occurred against 1,014 expected [observed/expected (O/E), 1.28; 95% confidence interval (CI), 1.21–1.35]. Sites contributing 25 or more excess cancers included leukemia (O/E, 4.17; O, 111; 95% CI, 3.43–5.03) and malignancies of colon (O/E, 1.33; O, 188; 95% CI, 1.15–1.54), rectum (O/E, 1.43; O, 76; 95% CI, 1.13–1.79), breast (O/E, 1.18; O, 404; 95%, CI 1.07–1.30), and bladder (O/E, 2.07; O, 65; 95% CI, 1.59–2.63). Ocular melanoma (O/E, 4.45; O, 8; 95% CI, 1.92–8.77) was also significantly increased. Second cancer risk was high during all follow-up intervals, and cumulative risk at 20 years was 18.2%, compared with a population expected risk of 11.5%. Statistically significant relationships existed between serous adenocarcinoma of the ovary and breast cancer (O/E, 1.29; 95% CI, 1.06–1.56) and mucinous ovarian adenocarcinoma and rectal cancer (O/E, 1.95; 95% CI, 1.09–3.22). Secondary leukemia appeared linked with antecedent chemotherapy, whereas radiotherapy was associated with cancers of connective tissue, bladder, and possibly pancreas. Genetic and reproductive factors predisposing to ovarian cancer may have contributed to the elevated risk of breast and colorectal neoplasms and possibly ocular melanoma. Thus, excess malignancies following ovarian cancer represent complications of curative therapies and/or underlying susceptibility states that have etiological and clinical ramifications.

¹ To whom requests for reprints should be addressed, at National Cancer Institute, EPN 408, Bethesda, MD 20892.

Received 11/27/95. Accepted 2/12/96.

This article has been cited by other articles:

				M. A. Lichtman Is There an Entity of Chemically Induced BCR-ABL-Positive Chronic Myelogenous Leukemia? Oncologist, June 1, 2008; 13(6): 645 - 654. [Abstract] [Full Text] [PDF]

				A. T. Meadows Pediatric Cancer Survivorship: Research and Clinical Care J. Clin. Oncol., November 10, 2006; 24(32): 5160 - 5165. [Abstract] [Full Text] [PDF]

				M. Shen, P. Boffetta, J. H. Olsen, A. Andersen, K. Hemminki, E. Pukkala, E. Tracey, D. H. Brewster, M. L. McBride, V. Pompe-Kirn, et al. A Pooled Analysis of Second Primary Pancreatic Cancer Am. J. Epidemiol., March 15, 2006; 163(6): 502 - 511. [Abstract] [Full Text] [PDF]

				N. Hearle, B. E. Damato, J. Humphreys, J. Wixey, H. Green, J. Stone, D. F. Easton, and R. S. Houlston Contribution of Germline Mutations in BRCA2, P16INK4A, P14ARF and P15 to Uveal Melanoma Invest. Ophthalmol. Vis. Sci., February 1, 2003; 44(2): 458 - 462. [Abstract] [Full Text] [PDF]

				J. M. Allan, C. P. Wild, S. Rollinson, E. V. Willett, A. V. Moorman, G. J. Dovey, P. L. Roddam, E. Roman, R. A. Cartwright, and G. J. Morgan Polymorphism in glutathione S-transferase P1 is associated with susceptibility to chemotherapy-induced leukemia PNAS, September 5, 2001; (2001) 191211198. [Abstract] [Full Text] [PDF]

				H. I. Hall, P. Jamison, and H. K. Weir Second Primary Ovarian Cancer Among Women Diagnosed Previously with Cancer Cancer Epidemiol. Biomarkers Prev., September 1, 2001; 10(9): 995 - 999. [Abstract] [Full Text] [PDF]

				D. S. Weinberg, C. J. Newschaffer, and A. Topham Risk for Colorectal Cancer after Gynecologic Cancer Ann Intern Med, August 3, 1999; 131(3): 189 - 193. [Abstract] [Full Text] [PDF]

				L. B. Travis, E. J. Holowaty, K. Bergfeldt, C. F. Lynch, B. A. Kohler, T. Wiklund, R. E. Curtis, P. Hall, M. Andersson, E. Pukkala, et al. Risk of Leukemia after Platinum-Based Chemotherapy for Ovarian Cancer N. Engl. J. Med., February 4, 1999; 340(5): 351 - 357. [Abstract] [Full Text] [PDF]

				C. A. Felix, A. H. Walker, B. J. Lange, T. M. Williams, N. J. Winick, N.-K. V. Cheung, B. D. Lovett, P. C. Nowell, I. A. Blair, and T. R. Rebbeck Association of CYP3A4 genotype with treatment-related leukemia PNAS, October 27, 1998; 95(22): 13176 - 13181. [Abstract] [Full Text] [PDF]

				J. M. Allan, C. P. Wild, S. Rollinson, E. V. Willett, A. V. Moorman, G. J. Dovey, P. L. Roddam, E. Roman, R. A. Cartwright, and G. J. Morgan Polymorphism in glutathione S-transferase P1 is associated with susceptibility to chemotherapy-induced leukemia PNAS, September 25, 2001; 98(20): 11592 - 11597. [Abstract] [Full Text] [PDF]