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Risk of Second Primary Neoplasms Among Cancer Survivors: A Population-Based, Cohort Study in Golestan Province, Northern Iran, 2004–2019 Publisher Pubmed



Hasanpourheidari S1 ; Semnani S1 ; Fazel A2 ; Naeimitabiei M2 ; Mehrjerdian M3 ; Sedaghat S4 ; Sadeghzadeh H4 ; Salamat F1 ; Jafaridelouei N1 ; Ghasemikebria F1 ; Mirkarimi H1 ; Shokouhifar N1 ; Abediardekani B5 ; Weiderpass E6 Show All Authors
Authors
  1. Hasanpourheidari S1
  2. Semnani S1
  3. Fazel A2
  4. Naeimitabiei M2
  5. Mehrjerdian M3
  6. Sedaghat S4
  7. Sadeghzadeh H4
  8. Salamat F1
  9. Jafaridelouei N1
  10. Ghasemikebria F1
  11. Mirkarimi H1
  12. Shokouhifar N1
  13. Abediardekani B5
  14. Weiderpass E6
  15. Roshandel G1
  16. Malekzadeh R7
Show Affiliations
Authors Affiliations
  1. 1. Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
  2. 2. Cancer Research Center, Golestan University of Medical Sciences, Gorgan, Iran
  3. 3. Department of Pathology, Golestan University of Medical Sciences, Gorgan, Iran
  4. 4. Deputy of Public Health, Golestan University of Medical Sciences, Gorgan, Iran
  5. 5. International Agency for Research on Cancer (IARC), Lyon, France
  6. 6. Office of the Director, International Agency for Research on Cancer (IARC), Lyon, France
  7. 7. Digestive Oncology Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran

Source: Cancer Medicine Published:2025


Abstract

Background: Recent reports of the Golestan population-based cancer registry (GPCR) suggested increasing trends in the incidence and survival rates of cancers in Golestan, Northern Iran. We investigated the risk of developing second primary neoplasms (SPNs) among cancer survivors in Golestan. Methods: The GPCR cases for whom a first primary cancer was diagnosed between 2004 and 2019 were included as cohort participants. The cohort members were followed by the end of 2020, and the occurrence of a second primary neoplasm (SPN) was considered as the study outcome event. The standardized incidence ratios (SIRs) and the Absolute excess risks (AERs), with corresponding 95% confidence intervals (95% CI) were calculated to evaluate the risk of SPNs. Results: Of the total 32,980 cases with first primary cancer, with a median follow-up of 3.4 years, 772 (2.3%) SPNs were registered. Our findings suggested a significantly higher risk of occurring new neoplasms among cancer survivors, with a SIR of 4.6 (95% CI: 4.3–4.9) and an AER of 41.8 per 10,000 person-years (95% CI: 37.6–46.0). Rural residents had a higher risk of SPN (SIR = 5.48) than urban dwellers (SIR = 3.99). Patients with first primary cancers of the ovary (SIR = 6.83) and prostate (SIR = 6.72) had the highest risk of any SPNs. The highest risk of site-specific SPNs was observed for the SPNs of the ovary (SIR = 8.11) and NHL (SIR = 7.07). Conclusions: Our results suggest that cancer patients are at significantly higher risk of getting a new neoplasm than the general population. These findings highlight the need for designing and implementing efficient surveillance programs for cancer survivors. © 2025 The Author(s). Cancer Medicine published by John Wiley & Sons Ltd.
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