Risk of second primary cancers in patients with rectal neuroendocrine neoplasms - a surveillance, epidemiology, and end results analysis

Sep 24, 2026

Elevated risk of second primary cancers (SPCs) has been reported across many malignancies, yet the magnitude of this risk in rectal neuroendocrine neoplasm (NEN) survivors remains unquantified. Survivors with first rectal NEN diagnoses from 2000–2018 were identified from SEER-18 registries, excluding synchronous primaries with a latency window. Relative risk was estimated using standardized incidence ratios (SIRs) calculated with SEER*Stat.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages11

Reading Time28 min

AccessFree to download

Introduction

Materials and methods

Statistical analysis

Results

Conclusion

TYPE Original Research PUBLISHED 13 September 2023 DOI 10.3389/fonc.2023.1248268 OPEN ACCESS EDITED BY Zequn Li, The Afﬁliated Hospital of Qingdao University, China REVIEWED BY Chuncheng Yang, Shandong University, China Fu Gang Wang, Qingdao Municipal Hospital, China *CORRESPONDENCE Xianli Zhou [hrbzhouxl@163.com](hrbzhouxl@163.com) RECEIVED 02 August 2023 ACCEPTED 21 August 2023 PUBLISHED 13 September 2023 CITATION Wan M, Wu J, Jiang Z, Gong W and Zhou X (2023) Risk of second primary cancers inpatients with rectal neuroendocrine neoplasms: a surveillance, epidemiology, and end results analysis. Front. Oncol. 13:1248268 . doi: 10.3389/fonc.2023.1248268 COPYRIGHT © 2023 Wan, Wu, Jiang, Gong and Zhou. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. Risk of second primary cancersin patients with rectal neuroendocrine neoplasms: a surveillance, epidemiology, and end results analysis Ming Wan, Jiaqi Wu, Zhaopeng Jiang, Wushuang Gong and Xianli Zhou* In-Patient Ultrasound Department, Second Afﬁliated Hospital of Harbin Medical University, Surgeons’Hall, Harbin, Heilongjiang, China Background: While an elevated risk of second primary cancers (SPCs) has been observed in many other cancers, risk of SPCs has not been quantiﬁed in patients with rectal neuroendocrine neoplasms (NENs) . Methods: Survivors of primary rectal NENs diagnosed between 2000 and 2018 were identiﬁed from the Surveillance, Epidemiology, and End Results (SEER)-18 registries. Relative risk of SPCs was estimated as the standardized incidence ratio (SIR), which was calculated using SEER*Stat software. Results: Between 2000 and 2018, a total of 15836 patients diagnosed with rectal NENs, of whom 1436 (9 . 1%) received diagnosis of SPCs (SIR: 1 . 19, 95%CI: 1 .13- 1. 26) . The majority of patients were aged 50-69 and had their ﬁrst cancer diagnosed at the localized stage. Male survivors had a higher propensity for developing SPCs overall, while female survivors exhibited higher risks of speciﬁc SPCs. Age at diagnosis of rectal NENs inﬂuenced the risk of SPCs, with younger patients having greater risks. A statistically signiﬁcant increase in the incidence of SPCs was observed among patients aged 30-64 years. Black patients had higher relative risks of certain SPCs, while White patients had a lower risk of subsequent melanoma. Trend analysis revealed that the highest excess burden of SPCs was observed in the years 2000 to 2002 . Risk of SPCs remained elevated within the ﬁrst four years post-diagnosis for survivors of rectal NENs, but diminished thereafter. Conclusion: The study revealed that individuals who survived rectal NENs were at an elevated risk of developing SPCs compared to the general population. Our results hold important implications for the formulation of lifelong surveillance recommendations for cancer survivors. KEYWORDS rectal NENs, second primary cancer, Sir, Ear, SEER Frontiers in Oncology 01 [frontiersin.org](frontiersin.org) Introduction Neuroendocrine neoplasms (NENs) are a heterogeneous group of uncommon diseases with varied clinical characteristics and biological behaviors which arising from neuroendocrine cells throughout the diffuse endocrine system (1, 2) . Due to advancesin diagnostic technologies, there has been a signiﬁcant increase in the detection of NENs both in the United States and globally (3–5) . Rectal NENs are one of the main subtypes of NENs in the gastrointestinal tract (6, 7) . Despite the typically indolent nature of rectal NENs and the improving outcomes in cancer management, surv

FAQs

How were patients with rectal neuroendocrine neoplasms selected for the study?

Histologically diagnosed rectal NEN patients were extracted from SEER-18 registries for diagnoses between 2000 and 2018, representing nearly 28% of the U.S. population. A latency window of at least two months between the first rectal NEN diagnosis and SPCs was used to exclude synchronous primary malignancies.

What statistical approach quantified the risk of second primary cancers?

The study used the standardized incidence ratio (SIR) to estimate relative risk of SPCs. SIRs were calculated with SEER*Stat software.

What did the study find about the overall risk of SPCs after rectal NEN?

Among 15,836 rectal NEN patients, 1,436 (9.1%) received a diagnosis of SPCs. SPC risk remained elevated compared with the general population for up to the first four years after diagnosis.

Sep 24, 2026

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