Second Primary Cancers After Liver, Gallbladder and Bile Duct Cancers, and These Cancers as Second Primary Cancers

Figures & data

Table 1 Characteristics of the Cancer Patients Included in the Study

Characteristics		Hepatocellular Carcinoma		Gallbladder Cancer		Bile Duct Cancer		Other Cancers
Median Age at Diagnosis (IQR)		71 (62–78)		73 (65–80)		72 (64–80)		69 (59–78)
		N	%	N	%	N	%	N	%
Year of diagnosis	1990–1995	2285	22.9	1883	35.7	1176	24.9	213,842	20.1
	1996–2000	1698	17.0	1100	20.9	896	19.0	187,159	17.6
	2001–2005	1717	17.2	858	16.3	823	17.4	205,822	19.4
	2006–2010	1806	18.1	715	13.6	817	17.3	218,218	20.5
	2011–2015	2491	24.9	721	13.7	1009	21.4	238,755	22.4
Gender	Male	6485	64.9	1365	25.9	2252	47.7	553,389	52.0
	Female	3512	35.1	3912	74.1	2469	52.3	510,407	48.0
Place of residence	Big cities	4736	47.4	1973	37.4	2127	45.1	496,423	46.7
	South Sweden	3019	30.2	2151	40.8	1677	35.5	363,923	34.2
	North Sweden	2185	21.9	1146	21.7	910	19.3	200,655	18.9
	Unspecified	57	0.6	7	0.1	7	0.2	2795	0.3
Socioeconomic status	Agriculture	64	0.6	49	0.9	58	1.2	43,524	1.3
	Private	348	3.5	117	2.2	157	3.3	66,090	3.4
	Professional	502	5.0	213	4.0	263	5.6	103,703	7.5
	Blue collar	1376	13.8	688	13.0	769	16.3	339,808	19.9
	Worker	2138	21.4	1035	19.6	1005	21.3	442,109	22.7
	Other	5569	55.7	3175	60.2	2469	52.3	68,562	45.3
All		9997	100	5277	100	4721	100	1,063,796	100

Abbreviation: IQR, inter quartile range.

Table 2 Risks of SPCs After Hepatocellular Carcinoma (HCC) and Those of HCC as SPCs

Cancer Site	SPC After HCC				HCC as SPC
	N	SIR	95% CI		N	SIR	95% CI
UAT	8	1.19	0.51	2.36	40	2.13	1.52	2.91
Esophagus	3	0.82	0.15	2.43	11	2.43	1.21	4.36
Stomach	7	0.76	0.30	1.58	18	1.22	0.72	1.93
Small intestine	3	2.12	0.40	6.28	10	3.01	1.44	5.56
CRC	38	0.99	0.70	1.36	117	1.15	0.95	1.38
Gallbladder	8	4.38	1.87	8.67	6	2.88	1.04	6.31
Bile ducts	2	1.13	0.11	4.16	4	1.84	0.48	4.77
Pancreas	14	1.58	0.86	2.65	7	0.84	0.33	1.75
Lung	27	0.94	0.62	1.36	44	1.22	0.89	1.64
Breast	9	0.46	0.21	0.88	93	1.08	0.87	1.32
Endometrium	6	1.16	0.42	2.54	26	1.18	0.77	1.73
Ovary	4	1.36	0.35	3.51	7	0.81	0.32	1.68
Prostate	40	0.50	0.36	0.68	232	0.80	0.70	0.91
Kidney	16	2.92	1.66	4.75	32	2.14	1.46	3.02
Left	4	1.76	0.46	4.54	13	2.13	1.13	3.65
Right	10	3.44	0.89	8.89	10	1.70	0.81	3.13
Bladder	17	0.95	0.55	1.52	87	1.64	1.31	2.02
Melanoma	4	0.42	0.11	1.09	25	0.74	0.48	1.09
Skin SCC	27	1.55	1.02	2.26	58	1.45	1.10	1.88
Nervous system	9	1.52	0.69	2.89	14	0.85	0.46	1.43
Thyroid	5	4.13	1.30	9.70	9	2.13	0.97	4.07
Endocrine	7	2.25	0.89	4.65	22	1.46	0.91	2.21
NHL	14	1.36	0.74	2.29	41	1.58	1.14	2.15
Myeloma	4	0.89	0.23	2.30	12	1.19	0.61	2.08
Leukemia	3	0.33	0.06	0.98	21	0.99	0.61	1.51
All	297	1.04	0.92	1.16	1012	1.19	1.12	1.27

Note: Bolding shows that the 95% CI does not overlap with 1.00.

Abbreviations: N, patient number; SIR, standardized incidence ratio; 95% CI, 95% confidence interval; SPC, second primary cancer; UAT, upper aerodigestive tract; CRC, colorectal cancer; HCC, hepatocellular carcinoma; NHL, non-Hodgkin lymphoma.

Table 3 Risks of SPCs After Gallbladder Cancer and Those of Gallbladder Cancer as SPC

Cancer Site	SPC After Gallbladder Cancer				Gallbladder Cancer as SPC
	N	SIR	95% CI		N	SIR	95% CI
UAT	1	0.34	0	1.94	6	0.86	0.31	1.89
Esophagus	1	0.65	0	3.72	0
Stomach	7	1.38	0.55	2.86	6	0.86	0.31	1.88
Small intestine	3	3.6	0.68	10.6	6	3.64	1.31	7.98
CRC	19	0.82	0.50	1.29	44	0.85	0.61	1.14
HCC	6	2.88	1.04	6.31	8	4.38	1.87	8.67
Bile ducts	6	5.05	1.82	11.06	2	1.71	0.16	6.27
Pancreas	4	0.70	0.18	1.80	9	1.91	0.87	3.65
Lung	7	0.49	0.19	1.01	9	0.56	0.25	1.07
Breast	14	0.56	0.30	0.94	76	0.83	0.66	1.04
Endometrium	6	0.85	0.31	1.87	27	1.11	0.73	1.62
Ovary	7	1.71	0.68	3.54	9	0.93	0.42	1.78
Prostate	15	0.78	0.44	1.30	39	0.61	0.44	0.84
Kidney	9	3.04	1.38	5.80	4	0.56	0.15	1.46
Left	4	3.44	0.90	8.90	1	0.37	0	2.11
Right	4	3.44	0.89	8.89	2	0.76	0.07	2.79
Bladder	5	0.7	0.22	1.65	16	0.89	0.51	1.45
Melanoma	4	0.79	0.21	2.05	14	0.89	0.48	1.49
Skin SCC	6	0.59	0.21	1.29	19	0.97	0.59	1.52
Nervous system	2	0.54	0.05	1.99	7	0.75	0.30	1.56
Thyroid	1	1.10	0	6.32	0
Endocrine	1	0.41	0	2.33	9	0.86	0.39	1.65
NHL	1	0.17	0	0.98	10	0.79	0.38	1.46
Myeloma	0				2	0.39	0.04	1.45
Leukemia	4	0.80	0.21	2.07	11	1.12	0.55	2.01
All	143	0.88	0.75	1.04	351	0.86	0.77	0.95

Note: Bolding shows that the 95% CI does not overlap with 1.00.

Abbreviations: N, patient number; SIR, standardized incidence ratio; 95% CI, 95% confidence interval; SPC, second primary cancer; UAT, upper aerodigestive tract; CRC, colorectal cancer; HCC, hepatocellular carcinoma; NHL, non-Hodgkin lymphoma.

Table 4 Risks of SPCs After Bile Duct Cancer and That of Bile Ductal Cancer as SPC

Cancer Site	SPC After Bile Duct Cancer				Bile Duct Cancer as SPC
	N	SIR	95% CI		N	SIR	95% CI
UAT	2	0.58	0.05	2.13	11	1.37	0.68	2.46
Esophagus	0				1	0.55	0	3.12
Stomach	6	1.22	0.44	2.67	2	0.30	0.03	1.11
Small intestine	3	3.67	0.69	10.9	6	3.73	1.34	8.17
CRC	19	0.84	0.51	1.32	61	1.20	0.92	1.54
HCC	4	1.84	0.48	4.77	2	1.13	0.11	4.16
Gallbladder	2	1.71	0.16	6.27	6	5.05	1.82	11.1
Pancreas	14	2.80	1.53	4.71	8	2.09	0.89	4.13
Lung	9	0.59	0.27	1.13	9	0.58	0.26	1.10
Breast	15	0.93	0.52	1.54	80	1.25	0.99	1.55
Endometrium	2	0.46	0.04	1.68	21	1.25	0.77	1.91
Ovary	4	1.66	0.43	4.30	2	0.32	0.03	1.18
Prostate	27	0.70	0.46	1.02	74	0.68	0.53	0.85
Kidney	6	2.03	0.73	4.45	7	1.01	0.40	2.09
Left	5	4.09	1.29	9.61	3	1.07	0.20	3.16
Right	1	0.83	0	4.74	3	1.10	0.21	3.27
Bladder	3	0.32	0.06	0.95	27	1.19	0.78	1.73
Melanoma	3	0.54	0.10	1.61	10	0.59	0.28	1.09
Skin SCC	6	0.55	0.20	1.20	23	1.07	0.68	1.61
Nervous system	2	0.6	0.06	2.21	5	0.60	0.19	1.41
Thyroid	2	2.72	0.26	10.0	1	0.44	0	2.51
Endocrine	1	0.50	0	2.89	8	0.93	0.40	1.84
NHL	3	0.52	0.10	1.53	14	1.13	0.62	1.90
Myeloma	0				5	1.05	0.33	2.48
Leukemia	4	0.78	0.20	2.01	13	1.29	0.68	2.21
All	147	0.88	0.75	1.04	420	1.01	0.92	1.12

Note: Bolding shows that the 95% CI does not overlap with 1.00.

Abbreviations: N, patient number; SIR, standardized incidence ratio; 95% CI, 95% confidence interval; SPC, second primary cancer; UAT, upper aerodigestive tract; CRC, colorectal cancer; HCC, hepatocellular carcinoma; NHL, non-Hodgkin lymphoma.