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Incidence, Risk and Trends of Multiple Primary Cancers in Patients With Colorectal Cancer: Evidence From the South Australian Cancer Registry
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Incidence, Risk and Trends of Multiple Primary Cancers in Patients With Colorectal Cancer: Evidence From the South Australian Cancer Registry
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Journal Article
Incidence, Risk and Trends of Multiple Primary Cancers in Patients With Colorectal Cancer: Evidence From the South Australian Cancer Registry
2025
Overview
Background Colorectal cancer (CRC) is the fourth most diagnosed cancer in Australia. With advancements in treatment and an increase in survival rates, CRC survivors face an elevated risk of developing multiple primary cancers (MPCs), presenting a clinical challenge. Therefore, this study aimed to estimate the incidence, trend and risk of MPCs after a diagnosis of CRC in the South Australian population. Methods This study analysed South Australian Cancer Registry data on individuals diagnosed with CRC as their first cancer from 1982 to 2017. The incidence of MPCs was assessed using cumulative incidence functions, and age‐standardised rates were estimated. Poisson regression was used to determine the risk, and standardised incidence ratios (SIR) and absolute excess risks (AER) were estimated. Trends over time were analysed using Joinpoint regression. Results The study included 26,729 CRC survivors. Of the cohort, 15% (3917) developed 4453 MPCs, with 96% diagnosed six or more months after index CRC. The cumulative incidence of MPCs was 22.5% (95% CI: 21.6–23.4). The median follow‐up time until MPC diagnosis was 6.4 years. Common MPCs included prostate (18.9%), subsequent CRC (13.1%), lung (10.8%), haematological (10.2%) and breast (8.0%) cancers. The overall risk of MPCs was higher in CRC survivors (SIR: 1.12, 95% CI: 1.09–1.16; AER: 22.6 per 10,000) compared to the incidence in the general South Australian population. The incidence of MPCs has increased over time (annual percentage change = 1.95, 95% CI: 1.33–2.51). Conclusions CRC survivors are at increased risk of subsequent cancers, highlighting the need for targeted surveillance, particularly for prostate, lung, breast and blood cancers, for early detection and treatment. In this study, the risk and trends of multiple primary cancers were estimated using large state‐wide data collected over 35 years. The findings revealed a significantly higher risk of subsequent primary cancers, with an increasing trend over time. These results underscore the need for informed strategies to enhance and refine surveillance programmes for the early detection of subsequent cancers. Such measures could improve not only overall survival but also the quality of survivorship by addressing long‐term health risks more effectively.
Publisher
John Wiley & Sons, Inc,Wiley
Subject
