Time from incident primary cancer until recurrence or second primary cancer: Risk factors and impact in general practice
Objective Specialised follow‐up care after cancer treatment is changing towards increased involvement of general practice. To ensure timely detection of new cancer events, knowledge is warranted on the timing of cancer recurrence (CR) and second primary cancer (SPC), including risk factors for CR. M...
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| Veröffentlicht in: | European journal of cancer care 2019-09, Vol.28 (5), p.e13123-n/a |
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| creator | Rasmussen, Linda Aagaard Jensen, Henry Virgilsen, Line Flytkjær Falborg, Alina Zalounina Møller, Henrik Vedsted, Peter |
| description | Objective
Specialised follow‐up care after cancer treatment is changing towards increased involvement of general practice. To ensure timely detection of new cancer events, knowledge is warranted on the timing of cancer recurrence (CR) and second primary cancer (SPC), including risk factors for CR.
Methods
This population‐based register study included 67,092 patients diagnosed with malignant melanoma, bladder, lung, ovarian, endometrial, colorectal and breast cancer in Denmark in 2008–2016. The time from primary cancer to CR or SPC and risk factors for prolonged time to CR were analysed and stratified on sex and primary cancer type.
Results
Cancer recurrence proportions ranged from 6% to 35%. The risk of CR increased profoundly within the first 3 years and then levelled off, except for breast cancer. A total of 3%–6% of patients had SPC, with monotonously increasing cumulative incidence proportions. Besides primary tumour characteristics, lower educational level, living alone and comorbidity were associated with earlier CR. For example, in female malignant melanoma, HRs and 95% confidence intervals were 0.47 (0.37–0.61) for high educational level, 1.40 (1.16–1.68) for living alone and 2.38 (1.53–3.70) for high comorbidity.
Conclusion
The results may inform stratified risk assessment in decision of frequency, location and duration of post‐cancer follow‐up care. |
| doi_str_mv | 10.1111/ecc.13123 |
| format | Article |
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Specialised follow‐up care after cancer treatment is changing towards increased involvement of general practice. To ensure timely detection of new cancer events, knowledge is warranted on the timing of cancer recurrence (CR) and second primary cancer (SPC), including risk factors for CR.
Methods
This population‐based register study included 67,092 patients diagnosed with malignant melanoma, bladder, lung, ovarian, endometrial, colorectal and breast cancer in Denmark in 2008–2016. The time from primary cancer to CR or SPC and risk factors for prolonged time to CR were analysed and stratified on sex and primary cancer type.
Results
Cancer recurrence proportions ranged from 6% to 35%. The risk of CR increased profoundly within the first 3 years and then levelled off, except for breast cancer. A total of 3%–6% of patients had SPC, with monotonously increasing cumulative incidence proportions. Besides primary tumour characteristics, lower educational level, living alone and comorbidity were associated with earlier CR. For example, in female malignant melanoma, HRs and 95% confidence intervals were 0.47 (0.37–0.61) for high educational level, 1.40 (1.16–1.68) for living alone and 2.38 (1.53–3.70) for high comorbidity.
Conclusion
The results may inform stratified risk assessment in decision of frequency, location and duration of post‐cancer follow‐up care.</description><identifier>ISSN: 0961-5423</identifier><identifier>EISSN: 1365-2354</identifier><identifier>DOI: 10.1111/ecc.13123</identifier><identifier>PMID: 31231898</identifier><language>eng</language><publisher>England: Hindawi Limited</publisher><subject>Aftercare ; Aged ; Bladder ; Breast cancer ; Breast Neoplasms - pathology ; Breast Neoplasms - therapy ; Cancer Survivors ; care transition ; Colorectal Neoplasms - pathology ; Colorectal Neoplasms - therapy ; Comorbidity ; Confidence intervals ; Denmark - epidemiology ; Disease-Free Survival ; Education ; Educational Status ; Endometrial Neoplasms - pathology ; Endometrial Neoplasms - therapy ; Endometrium ; Female ; General Practice ; Health risks ; Humans ; Incidence ; Lung Neoplasms - pathology ; Lung Neoplasms - therapy ; Male ; Melanoma ; Melanoma - pathology ; Melanoma - therapy ; Melanoma, Cutaneous Malignant ; Metastasis ; Middle Aged ; Neoplasm Recurrence, Local - epidemiology ; Neoplasms - pathology ; Neoplasms - therapy ; Neoplasms, Second Primary - epidemiology ; Ovarian Neoplasms - pathology ; Ovarian Neoplasms - therapy ; Population studies ; primary health care ; Proportional Hazards Models ; recurrence ; Registries ; Residence Characteristics ; Risk analysis ; Risk assessment ; Risk factors ; second primary neoplasms ; Sex Factors ; Skin cancer ; Skin Neoplasms - pathology ; Skin Neoplasms - therapy ; Time Factors ; Tumors ; Urinary Bladder Neoplasms - pathology ; Urinary Bladder Neoplasms - therapy</subject><ispartof>European journal of cancer care, 2019-09, Vol.28 (5), p.e13123-n/a</ispartof><rights>2019 John Wiley & Sons Ltd</rights><rights>2019 John Wiley & Sons Ltd.</rights><rights>Copyright © 2019 John Wiley & Sons Ltd</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3883-6fa58e575b45c771c1a45d9d90b6cd8113900bfeb836c55a99ff5cd9805c77513</citedby><cites>FETCH-LOGICAL-c3883-6fa58e575b45c771c1a45d9d90b6cd8113900bfeb836c55a99ff5cd9805c77513</cites><orcidid>0000-0003-4040-7334 ; 0000-0002-9753-2008</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fecc.13123$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fecc.13123$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1416,27922,27923,45572,45573</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31231898$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Rasmussen, Linda Aagaard</creatorcontrib><creatorcontrib>Jensen, Henry</creatorcontrib><creatorcontrib>Virgilsen, Line Flytkjær</creatorcontrib><creatorcontrib>Falborg, Alina Zalounina</creatorcontrib><creatorcontrib>Møller, Henrik</creatorcontrib><creatorcontrib>Vedsted, Peter</creatorcontrib><title>Time from incident primary cancer until recurrence or second primary cancer: Risk factors and impact in general practice</title><title>European journal of cancer care</title><addtitle>Eur J Cancer Care (Engl)</addtitle><description>Objective
Specialised follow‐up care after cancer treatment is changing towards increased involvement of general practice. To ensure timely detection of new cancer events, knowledge is warranted on the timing of cancer recurrence (CR) and second primary cancer (SPC), including risk factors for CR.
Methods
This population‐based register study included 67,092 patients diagnosed with malignant melanoma, bladder, lung, ovarian, endometrial, colorectal and breast cancer in Denmark in 2008–2016. The time from primary cancer to CR or SPC and risk factors for prolonged time to CR were analysed and stratified on sex and primary cancer type.
Results
Cancer recurrence proportions ranged from 6% to 35%. The risk of CR increased profoundly within the first 3 years and then levelled off, except for breast cancer. A total of 3%–6% of patients had SPC, with monotonously increasing cumulative incidence proportions. Besides primary tumour characteristics, lower educational level, living alone and comorbidity were associated with earlier CR. For example, in female malignant melanoma, HRs and 95% confidence intervals were 0.47 (0.37–0.61) for high educational level, 1.40 (1.16–1.68) for living alone and 2.38 (1.53–3.70) for high comorbidity.
Conclusion
The results may inform stratified risk assessment in decision of frequency, location and duration of post‐cancer follow‐up care.</description><subject>Aftercare</subject><subject>Aged</subject><subject>Bladder</subject><subject>Breast cancer</subject><subject>Breast Neoplasms - pathology</subject><subject>Breast Neoplasms - therapy</subject><subject>Cancer Survivors</subject><subject>care transition</subject><subject>Colorectal Neoplasms - pathology</subject><subject>Colorectal Neoplasms - therapy</subject><subject>Comorbidity</subject><subject>Confidence intervals</subject><subject>Denmark - epidemiology</subject><subject>Disease-Free Survival</subject><subject>Education</subject><subject>Educational Status</subject><subject>Endometrial Neoplasms - pathology</subject><subject>Endometrial Neoplasms - therapy</subject><subject>Endometrium</subject><subject>Female</subject><subject>General Practice</subject><subject>Health risks</subject><subject>Humans</subject><subject>Incidence</subject><subject>Lung Neoplasms - pathology</subject><subject>Lung Neoplasms - therapy</subject><subject>Male</subject><subject>Melanoma</subject><subject>Melanoma - pathology</subject><subject>Melanoma - therapy</subject><subject>Melanoma, Cutaneous Malignant</subject><subject>Metastasis</subject><subject>Middle Aged</subject><subject>Neoplasm Recurrence, Local - epidemiology</subject><subject>Neoplasms - pathology</subject><subject>Neoplasms - therapy</subject><subject>Neoplasms, Second Primary - epidemiology</subject><subject>Ovarian Neoplasms - pathology</subject><subject>Ovarian Neoplasms - therapy</subject><subject>Population studies</subject><subject>primary health care</subject><subject>Proportional Hazards Models</subject><subject>recurrence</subject><subject>Registries</subject><subject>Residence Characteristics</subject><subject>Risk analysis</subject><subject>Risk assessment</subject><subject>Risk factors</subject><subject>second primary neoplasms</subject><subject>Sex Factors</subject><subject>Skin cancer</subject><subject>Skin Neoplasms - pathology</subject><subject>Skin Neoplasms - therapy</subject><subject>Time Factors</subject><subject>Tumors</subject><subject>Urinary Bladder Neoplasms - pathology</subject><subject>Urinary Bladder Neoplasms - therapy</subject><issn>0961-5423</issn><issn>1365-2354</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp10UtLAzEQB_Agiq2Pg19AAl70sDbZJNvEmyy-oCCInpfs7KxE91GTLtpvb2qrh4K5hAy__BlmCDnh7JLHM0GASy54KnbImItMJalQcpeMmcl4omQqRuQghDfGIjJyn4xWlmujx-Tr2bVIa9-31HXgKuwWdO5da_2Sgu0APR26hWuoRxi8x1ihvacBoe-qLXlFn1x4p7WFRe8DtRG4dh5fMZq-YofeNvFLLDjAI7JX2ybg8eY-JC-3N8_5fTJ7vHvIr2cJCK1FktVWaVRTVUoF0ykHbqWqTGVYmUGlOReGsbLGUosMlLLG1LWCymi24oqLQ3K-zp37_mPAsChaFwCbxnbYD6FIU5mlMlWZjvRsi771g-9id1GZKZMZlyt1sVbg-xA81sVmCgVnxWodRVxH8bOOaE83iUPZYvUnf-cfwWQNPl2Dy_-Tips8X0d-Azz2k_Q</recordid><startdate>201909</startdate><enddate>201909</enddate><creator>Rasmussen, Linda Aagaard</creator><creator>Jensen, Henry</creator><creator>Virgilsen, Line Flytkjær</creator><creator>Falborg, Alina Zalounina</creator><creator>Møller, Henrik</creator><creator>Vedsted, Peter</creator><general>Hindawi Limited</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>8FD</scope><scope>ASE</scope><scope>FPQ</scope><scope>FR3</scope><scope>K6X</scope><scope>K9.</scope><scope>M7Z</scope><scope>NAPCQ</scope><scope>P64</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-4040-7334</orcidid><orcidid>https://orcid.org/0000-0002-9753-2008</orcidid></search><sort><creationdate>201909</creationdate><title>Time from incident primary cancer until recurrence or second primary cancer: Risk factors and impact in general practice</title><author>Rasmussen, Linda Aagaard ; Jensen, Henry ; Virgilsen, Line Flytkjær ; Falborg, Alina Zalounina ; Møller, Henrik ; Vedsted, Peter</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3883-6fa58e575b45c771c1a45d9d90b6cd8113900bfeb836c55a99ff5cd9805c77513</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Aftercare</topic><topic>Aged</topic><topic>Bladder</topic><topic>Breast cancer</topic><topic>Breast Neoplasms - pathology</topic><topic>Breast Neoplasms - therapy</topic><topic>Cancer Survivors</topic><topic>care transition</topic><topic>Colorectal Neoplasms - pathology</topic><topic>Colorectal Neoplasms - therapy</topic><topic>Comorbidity</topic><topic>Confidence intervals</topic><topic>Denmark - epidemiology</topic><topic>Disease-Free Survival</topic><topic>Education</topic><topic>Educational Status</topic><topic>Endometrial Neoplasms - pathology</topic><topic>Endometrial Neoplasms - therapy</topic><topic>Endometrium</topic><topic>Female</topic><topic>General Practice</topic><topic>Health risks</topic><topic>Humans</topic><topic>Incidence</topic><topic>Lung Neoplasms - pathology</topic><topic>Lung Neoplasms - therapy</topic><topic>Male</topic><topic>Melanoma</topic><topic>Melanoma - pathology</topic><topic>Melanoma - therapy</topic><topic>Melanoma, Cutaneous Malignant</topic><topic>Metastasis</topic><topic>Middle Aged</topic><topic>Neoplasm Recurrence, Local - epidemiology</topic><topic>Neoplasms - pathology</topic><topic>Neoplasms - therapy</topic><topic>Neoplasms, Second Primary - epidemiology</topic><topic>Ovarian Neoplasms - pathology</topic><topic>Ovarian Neoplasms - therapy</topic><topic>Population studies</topic><topic>primary health care</topic><topic>Proportional Hazards Models</topic><topic>recurrence</topic><topic>Registries</topic><topic>Residence Characteristics</topic><topic>Risk analysis</topic><topic>Risk assessment</topic><topic>Risk factors</topic><topic>second primary neoplasms</topic><topic>Sex Factors</topic><topic>Skin cancer</topic><topic>Skin Neoplasms - pathology</topic><topic>Skin Neoplasms - therapy</topic><topic>Time Factors</topic><topic>Tumors</topic><topic>Urinary Bladder Neoplasms - pathology</topic><topic>Urinary Bladder Neoplasms - therapy</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Rasmussen, Linda Aagaard</creatorcontrib><creatorcontrib>Jensen, Henry</creatorcontrib><creatorcontrib>Virgilsen, Line Flytkjær</creatorcontrib><creatorcontrib>Falborg, Alina Zalounina</creatorcontrib><creatorcontrib>Møller, Henrik</creatorcontrib><creatorcontrib>Vedsted, Peter</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Technology Research Database</collection><collection>British Nursing Index</collection><collection>British Nursing Index (BNI) (1985 to Present)</collection><collection>Engineering Research Database</collection><collection>British Nursing Index</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Biochemistry Abstracts 1</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>European journal of cancer care</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Rasmussen, Linda Aagaard</au><au>Jensen, Henry</au><au>Virgilsen, Line Flytkjær</au><au>Falborg, Alina Zalounina</au><au>Møller, Henrik</au><au>Vedsted, Peter</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Time from incident primary cancer until recurrence or second primary cancer: Risk factors and impact in general practice</atitle><jtitle>European journal of cancer care</jtitle><addtitle>Eur J Cancer Care (Engl)</addtitle><date>2019-09</date><risdate>2019</risdate><volume>28</volume><issue>5</issue><spage>e13123</spage><epage>n/a</epage><pages>e13123-n/a</pages><issn>0961-5423</issn><eissn>1365-2354</eissn><abstract>Objective
Specialised follow‐up care after cancer treatment is changing towards increased involvement of general practice. To ensure timely detection of new cancer events, knowledge is warranted on the timing of cancer recurrence (CR) and second primary cancer (SPC), including risk factors for CR.
Methods
This population‐based register study included 67,092 patients diagnosed with malignant melanoma, bladder, lung, ovarian, endometrial, colorectal and breast cancer in Denmark in 2008–2016. The time from primary cancer to CR or SPC and risk factors for prolonged time to CR were analysed and stratified on sex and primary cancer type.
Results
Cancer recurrence proportions ranged from 6% to 35%. The risk of CR increased profoundly within the first 3 years and then levelled off, except for breast cancer. A total of 3%–6% of patients had SPC, with monotonously increasing cumulative incidence proportions. Besides primary tumour characteristics, lower educational level, living alone and comorbidity were associated with earlier CR. For example, in female malignant melanoma, HRs and 95% confidence intervals were 0.47 (0.37–0.61) for high educational level, 1.40 (1.16–1.68) for living alone and 2.38 (1.53–3.70) for high comorbidity.
Conclusion
The results may inform stratified risk assessment in decision of frequency, location and duration of post‐cancer follow‐up care.</abstract><cop>England</cop><pub>Hindawi Limited</pub><pmid>31231898</pmid><doi>10.1111/ecc.13123</doi><tpages>15</tpages><orcidid>https://orcid.org/0000-0003-4040-7334</orcidid><orcidid>https://orcid.org/0000-0002-9753-2008</orcidid><oa>free_for_read</oa></addata></record> |
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| ispartof | European journal of cancer care, 2019-09, Vol.28 (5), p.e13123-n/a |
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| source | Wiley Online Library - AutoHoldings Journals; MEDLINE |
| subjects | Aftercare Aged Bladder Breast cancer Breast Neoplasms - pathology Breast Neoplasms - therapy Cancer Survivors care transition Colorectal Neoplasms - pathology Colorectal Neoplasms - therapy Comorbidity Confidence intervals Denmark - epidemiology Disease-Free Survival Education Educational Status Endometrial Neoplasms - pathology Endometrial Neoplasms - therapy Endometrium Female General Practice Health risks Humans Incidence Lung Neoplasms - pathology Lung Neoplasms - therapy Male Melanoma Melanoma - pathology Melanoma - therapy Melanoma, Cutaneous Malignant Metastasis Middle Aged Neoplasm Recurrence, Local - epidemiology Neoplasms - pathology Neoplasms - therapy Neoplasms, Second Primary - epidemiology Ovarian Neoplasms - pathology Ovarian Neoplasms - therapy Population studies primary health care Proportional Hazards Models recurrence Registries Residence Characteristics Risk analysis Risk assessment Risk factors second primary neoplasms Sex Factors Skin cancer Skin Neoplasms - pathology Skin Neoplasms - therapy Time Factors Tumors Urinary Bladder Neoplasms - pathology Urinary Bladder Neoplasms - therapy |
| title | Time from incident primary cancer until recurrence or second primary cancer: Risk factors and impact in general practice |
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