Boakye EA, et al. - Authors evaluated risks of second primary malignant neoplasm (SPMN) and its burden in a large US cohort of patients with a first potentially human papillomavirus (HPV)-associated head and neck squamous cell carcinoma (HNSCC) vs non–HPV-associated HNSCC. An increased risk of SPMN was seen in patients diagnosed with HNSCC. This risk was higher among those with non–HPV-associated HNSCC than from possibly HPV-associated HNSCC. Findings suggested that in patients with HNSCC, strategies that avert or detect SPMN early should be employed by clinicians.

Methods

• In this population-based retrospective cohort study, researchers identified 109,512 adult patients diagnosed with HNSCC between 2000 and 2014 from the Surveillance, Epidemiology, and End Results registry.
• The exposures included HPV-relatedness based on whether patients’ first HNSCC was potentially associated with HPV.
• They grouped the patients into 2 cohorts: potentially HPV-associated HNSCC, and non–HPV-associated HNSCC.
• The primary outcome included incidence of SPMN, defined as the first subsequent primary cancer occurring at least 2 months after first cancer diagnosis.
• They calculated the excess SPMN risk using relative (standardized incidence ratios [SIRs]) and absolute (excess absolute risk [EAR] per 10,000 person-years at risk [PYR]).

Results

• As per data, a total of 109,512 patients with HNSCC (mean [SD] age, 61.9 [12.1] years; 83,305 [76.1%] men) were identified.
• Findings suggested that the overall SIR was 2.18 (95% CI, 2.14-2.22) corresponding to 160 excess cases per 10,000 PYR.
• Among patients with first potentially HPV-associated HNSCC (SIR, 1.98; EAR, 114 excess cases per 10,000 PYR), the risk was lower vs those with first non–HPV-associated HNSCC (SIR, 2.28; EAR, 188 excess cases per 10,000 PYR).
• Overall, in cancers of the head and neck, lung, and esophagus, the largest SIRs and EARs were observed.
• Nonetheless, lower risks of SPMN were noted among potentially HPV-associated HNSCC patients.