Other neoplasms among Czech survivors with bronchopulmonal cancer

The neoplasms following primary lung cancer (LC) and primary neoplasms before LC analyzed a retrospective study in survivors, notified

in the National Czech Cancer Registry between 1976 and 2010. A total 16 622 LC in males associated with other neoplasms, presented

10 % of 166 239 newly registered LC in males, of which were 4,395 (2.6 %) primary and 12,227 (7.4 %) subsequent LC; a total 5,322 LC in

females, presented 14.1 % of 37,619 newly registered LC in females, of which were 1,022 (2.7 %) primary and 4,300 (11.4 %) subsequent

LC. The average interval of occurrence of subsequent neoplasms was 4.1 years in males and 3.9 years in females. Among subsequent

neoplasms (after LC) were about 23 % cancers of digestive and 14% urinary tract, in males 14% cancers of respiratory tract, 14 % skin and

11 % prostate, in females 11% cancers of female genital organs, 11 % skin and 11% breast. Among primary neoplasms (before LC) were

about 38 % cancers of skin, 13 % urinary, 13 % digestive and 10 % respiratory tract in males; 27 % cancers of skin, 21 % female genital organs,

17% breast, 9 % digestive and 5 % urinary tract in females. The yearly number of primary LC has increased since 1976 to 2010 from

65 to 119 cases, their representation at the early clinical stages decreased in 5-year periods from 53% to 22 %, at the advanced stages

increased from 20 % to 64 %; the number of subsequent LC increased from 23 to 1089 cases, their early clinical stages decreased from

33 % to 20 %, the advanced stages increased from 29 % to 63 %. The higher proportion of LC at the unknown stages limited detailed

analysis. In our study were estimated about 1,155 neoplasms at the advanced stages (19 % in males and 22 % in females of all subsequent

neoplasms) diagnosed after primary LC, which presented a monthly average of three cancers during 34 years. The most frequented

advanced stages of 4,966 selected subsequent cancers were cancers of ovary (47 %), other lung (males 45 %, females 52 %), larynx (males

45 %, females 52 %), oral cavity (males 41 %, females 39 %), stomach (males 28 %, females 42%), colorectum (males 33%, females 37 %),

cervix uteri (28 %), breast (25 %) and pancreas (males 23 %, females 26 %). Mainly subsequent advanced stages must be prevented by the

follow-up guidelines and early interventions. Limited resources and continuing risks of lifestyle including smoking do not allow to slow

down the increase of primary and subsequent neoplasms in the near future among cancer survivors not in pneumology.

Keywords: lung cancer, cancer multiplicity, primary and subsequent neoplasms, time-space-age distribution, clinical stages