Risk of Subsequent Primary Cancers Among Adult-Onset 5-Year Cancer Survivors in South Korea - Retrospective Cohort Study

Q: What was the main goal of evaluating subsequent primary cancers (SPCs) in this study?

The study evaluated overall and cancer type–specific risks of SPCs among adult-onset 5-year cancer survivors, stratified by first primary cancer (FPC) type while considering sex and age.

Q: How were SPC risks measured and compared with the general population?

SPC incidence was calculated per 10,000 person-years, and the standardized incidence ratio (SIR) was used to compare observed SPC rates with those expected in the general population.

Q: Why does the study recommend tailored prevention and screening for cancer survivors?

The results showed SPC risk varied by age, sex, and FPC type, and young survivors had elevated SPC risk, supporting targeted prevention, screening programs, and possibly genetic testing.

Sep 21, 2026

Uploaded by Eliana

Background: Cancer survivors who develop subsequent primary cancers (SPCs) are expected to increase. Objective: Assess overall and cancer type–specific SPC risks among adult-onset 5-year cancer survivors by first primary cancer (FPC) type, considering sex and age. Methods: Retrospective cohort study using South Korea’s Health Insurance Review and Assessment database for survivors diagnosed with an FPC in 2009–2010, followed until Dec 31, 2019. Incidence per 10,000 person-years and standardized incidence ratios (SIRs) were compared with the general population. Results and Conclusions: Large cohort results showed overall reduced SPC risk versus general population, with age- and sex-specific and FPC-specific variation, implying tailored prevention, screening, and possible genetic evaluation, especially for young survivors.

LanguageEnglish

CategoryResearch & Report

FormatPDF

Pages13

Reading Time33 min

AccessFree to download

Abstract

Background and objective

Methods

Results

Conclusions

Introduction

Motivation and survivor burden

Need for FPC–SPC risk assessment

JMIR PUBLIC HEALTH AND SURVEILLANCE Choi et al Original Paper Risk of Subsequent Primary Cancers Among Adult-Onset 5-Year Cancer Survivors in South Korea: Retrospective Cohort Study | Yoon Young Choi 1*, MD, PhD; Myeongjee Lee2*, PhD; Eun Hwa Kim2, MS; Jae Eun Lee3, PhD; Inkyung Jung2*, PhD; Jae-Ho Cheong3, MD, PhD | | --- | | 1Department of Surgery, Soonchunhyang Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon si, Republic of Korea 2Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, Republic of Korea
3Department of Surgery, Yonsei University Health System, Yonsei University College of Medicine, Seoul, Republic of Korea
*these authors contributed equally
Corresponding Author:
Jae-Ho Cheong, MD, PhD Department of Surgery
Yonsei University Health System
Yonsei University College of Medicine Yonsei-ro 50
Seoul, 03722 Republic of Korea Phone: 82 2 2228 2094
Email: [jhcheong@yuhs.ac](jhcheong@yuhs.ac)
Abstract | | Background: The number of cancer survivors who develop subsequent primary cancers (SPCs) is expected to increase. Objective: We evaluated the overall and cancer type–specific risks ofSPCs among adult-onset cancer survivors by first primary cancer (FPC) types considering sex and age.
Methods: We conducted a retrospective cohort study using the Health Insurance Review and Assessment database of South Korea including 5-year cancer survivors diagnosed with an FPC in 2009 to 2010 and followed them until December 31, 2019. We measured the SPC incidence per 10,000 person-years and the standardized incidence ratio (SIR) compared with the incidence expected in the general population.
Results: Among 266,241 survivors (mean age at FPC: 55.7 years; 149,352/266,241, 56.1% women), 7348 SPCs occurred during 1,003,008 person-years of follow-up (median 4.3 years), representing a 26% lower risk of developing SPCs (SIR 0.74, 95% CI 0.72-0.76) . Overall, men with 14 of the 20 FPC types had a significantly lower risk of developing any SPCs; women with 7 of the 21 FPC types had a significantly lower risk of developing any SPCs. The risk of developing any SPC type differed by age; the risk was 28% higher in young (<40 years) cancer survivors (SIR 1.28, 95% CI 1.16-1.42; incidence: 30 per 10,000 person-years) and 27% lower in middle-aged and older (≥40 years) cancer survivors (SIR 0.73, 95% CI 0.71-0.74; incidence: 80 per 10,000 person-years) compared with the age-corresponding general population. The most common types ofFPCs were mainly observed as SPCs in cancer survivors, with lung (21.6%) and prostate (15.2%) cancers in men and breast (18.9%) and lung (12.2%) cancersin women. The risks of brain cancer in colorectal cancer survivors, lung cancer in laryngeal cancer survivors, and both kidney cancer and leukemia in thyroid cancer survivors were significantly higher for both sexes. Other high-risk SPCs varied by FPCtype and sex. Strong positive associations among smoking-related cancers, such as laryngeal, head and neck, lung, and esophageal cancers, were observed. Substantial variation existed in the associations between specific types ofFPC and specific types of SPC risk, which may be linked to hereditary cancer syndrome: for women, the risks of ovarian cancer for breast cancer survivors and uterus cancers for colorectal cancer survivors, and for men, the risk of pancreas cancer for kidney cancer survivors. Conclusions: The varying risk for SPCs by age, sex, and FPC types in cancer survivors implies the necessity for tailored prevention and screening programs targeting cancer survivors. Lifestyle modifications, such as smoking cessation, are essential to reduce the risk of SPCs in cancer survivors. In addition, genetic testing, along with proactive cancer screening and prevention strategies, should be implemented for young cancer survivors because of their elevated risk of developing SPCs.
(JMIR Public Health Surveill 2024;10:e48380) do

FAQs

What was the main goal of evaluating subsequent primary cancers (SPCs) in this study?

The study evaluated overall and cancer type–specific risks of SPCs among adult-onset 5-year cancer survivors, stratified by first primary cancer (FPC) type while considering sex and age.

How were SPC risks measured and compared with the general population?

SPC incidence was calculated per 10,000 person-years, and the standardized incidence ratio (SIR) was used to compare observed SPC rates with those expected in the general population.

Why does the study recommend tailored prevention and screening for cancer survivors?

The results showed SPC risk varied by age, sex, and FPC type, and young survivors had elevated SPC risk, supporting targeted prevention, screening programs, and possibly genetic testing.

Sep 21, 2026

Uploaded by Eliana