Second lung cancer risk in patients treated for cancer of the cervix: a Population-Based study in the SEER cancer registries

Abstract Background: As cervix cancer survival improves, the risk of developing a second cancer has become more important in particular lung cancer. However, the proportion of second primary non-small cell lung cancer after cervix cancer (CC-NSCLC) and associated clinical characteristics are unknown in comparison with first primary non-small cell lung cancer (NSCLC1). Methods: The Surveillance, Epidemiology and End Results (SEER) cancer registry was used to conduct a large population-based cohort analysis of 16768 patients diagnosed with cervical cancer and 173272 patients diagnosed with NSCLC1 between 1998 and 2010. The analysis included demographic, clinical characteristics, prognostic data and risk factors for CC-NSCLC. Results: 557 (3.3%) patients developed CC-NSCLC and 451 were eligible for inclusion in the final analyses. The mean age at CC-NSCLC diagnosis was 62.9 years old. In comparison to NSCLC1, patients with CC-NSCLC had a higher rate of squamous cell carcinoma (36.59% vs 19.07%) and were more likely to be diagnosed in young, unmarried and black subgroups. Median survival time was longer for CC-NSCLC than NSCLC-1 before but not propensity score matching. Localized stage, adenocarcinoma, young age, surgical records, no radiotherapy records and well differentiation were associated with better prognosis in CC-NSCLC cohort. Conclusion: Patients with cervical cancer are at high risk of developing second primary lung cancers. High-risk factors include squamous carcinoma, 50-70years old, black, divorce, history of chemo-radiation therapy and poor differentiation. Prevention in this population as regards the increased risk for second primary cancers is crucial in order to improve the prognosis of patients.