Seiki Kanemura

Subsequent primary cancer incidence in cervical cancer survivors: insights from a comprehensive cohort study utilizing combined Japanese population-based cancer registries

This study aimed to evaluate the incidence of subsequent primary cancer (SPC) among cervical cancer survivors in Japan. Data from the cancer registries of Osaka, Kanagawa, and Miyagi prefectures were combined. The cohort included individuals diagnosed with invasive and in situ cervical cancer between 1980 and 2010, with the SPC incidence evaluated until 2015. The incidence and standardized incidence ratio (SIR) for different SPC sites were calculated. In addition, the association between SPC and radiotherapy was examined via competitive regression analysis. A total of 49,824 cervical cancer survivors were followed for up to 35 years, during which 4,507 (9.0%) of these survivors experienced SPC. Aside from the initial cancer, SPC was the most common cause of death among cervical cancer survivors. The most frequent SPC sites were the colorectal, breast, lung, and stomach, consistent with the frequency in the general population. A significant increase in the SIRs for bladder, lung, and colorectal cancers was observed (2.52, 1.63, and 1.44, respectively). Individuals who underwent radiotherapy had a higher risk of developing bladder cancer than those who did not, with a subdistribution hazard ratio of 2.28. The SIR for lung cancer significantly increased, particularly for the smoking-associated types, indicating the influence of smoking habits among survivors. Increased risk of specific SPCs was seen in both invasive and in situ cancer survivors. Cervical cancer survivors should be informed about the risks of SPCs and educated on the prevention methods. Our study provides valuable insights into specific actions SPC prevention.

Trends in 5-year net survival for women diagnosed with breast, cervical or ovarian cancer in Japan, 2000–14 (CONCORD-3)

Abstract Background Breast, cervical and ovarian cancers significantly affect young and middle-aged women, both physically and socially. However, relevant comprehensive stratified analyses are limited. Using Japanese data from CONCORD-3, a global cancer survival surveillance program, we analyzed long-term survival trends. Methods Data from 16 Japanese population-based cancer registries were analyzed for women diagnosed aged 15–99 years during 2000–2014 with a tumor originating in the breast, cervix uteri or ovaries. Follow-up was extended to five years post-diagnosis or until December 31st, 2014. In situ tumors and death-certificate-only registrations were excluded. Five-year net survival was estimated with the Pohar Perme estimator by calendar period of diagnosis, morphology and stage, and age-standardized with International Cancer Survival Standard weights. Results During 2000–2014, 5-year net survival improved for breast cancer from 85.9% (95% CI, 85.2–86.6%) to 89.4% (88.9–89.9%), for cervical cancer from 67.5% (66.3–68.7%) to 71.4% (70.4–72.3%), and for ovarian cancer from 35.5% (33.8–37.2%) to 46.3% (44.9–47.7%). Five-year survival for tumors diagnosed at a localized stage remained consistently high (>98% for breast cancer and > 90% for cervical cancer). Ovarian cancer survival varied greatly according to morphology. Conclusions Five-year net survival for women with cancers of the breast, cervix, and ovary) in Japan improved during 2000–2014, and remained at a globally high level throughout this period. These gains are probably attributable to earlier detection of breast and cervical cancers and advances in multimodal treatment for all cancers. Survival for distant-stage cervical and ovarian cancers remains a challenge, underscoring the need for enhanced screening and treatment strategies.