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@ARTICLE{Zheng:169802,
      author       = {G. Zheng$^*$ and K. Sundquist and J. Sundquist and T. Chen
                      and A. Försti$^*$ and A. Hemminki and K. Hemminki$^*$},
      title        = {{S}econd {P}rimary {C}ancers {A}fter {G}astric {C}ancer,
                      and {G}astric {C}ancer as {S}econd {P}rimary {C}ancer.},
      journal      = {Clinical epidemiology},
      volume       = {13},
      issn         = {1179-1349},
      address      = {Albany, Auckland},
      publisher    = {Dove Medical Press},
      reportid     = {DKFZ-2021-01556},
      pages        = {515 - 525},
      year         = {2021},
      note         = {#EA:C050#LA:C050#},
      abstract     = {Second primary cancers (SPCs) are increasing, which may
                      negatively influence patient survival. Gastric cancer (GC)
                      has poor survival and when it is diagnosed as SPC it is
                      often the cause of death. We wanted to analyze the risk of
                      SPCs after GC and the risk of GC as SPC after any cancer.
                      Such bidirectional analysis is important in relation to
                      fatal cancers because SPCs may be under-reported in the
                      short-term survival period.Cancers were obtained from the
                      Swedish Cancer Registry from years 1990 through 2015.
                      Standardized incidence ratios (SIRs) were used to estimate
                      bidirectional relative.We identified 23,137 GC patients who
                      developed 1042 SPCs $(4.5\%);$ 2158 patients had GC as SPC.
                      While the risk for three SPCs was increased after GC, seven
                      first primary cancers were followed by an increased risk of
                      GC as SPC, including esophageal, colorectal, bladder,
                      squamous cell skin and breast cancers and non-Hodgkin
                      lymphoma. Breast cancer, which was followed by a diagnosis
                      of second GC, showed an excess of lobular histology.Multiple
                      primary cancers in the same individuals may signal genetic
                      predisposition. Accordingly, the association of GC with
                      breast cancer may be related to mutations in the CDH1 gene,
                      and clustering of colorectal, small intestinal and bladder
                      cancers could be related to Lynch syndrome. The third line
                      of findings supports a contribution of immune dysfunction on
                      the increased risk of GC as SPC after skin cancer and
                      non-Hodgkin lymphoma. Early detection of GC in the risk
                      groups could save lives.},
      keywords     = {cancer etiology (Other) / cancer incidence (Other) /
                      relative risk (Other) / second primary cancer (Other) /
                      stomach cancer (Other)},
      cin          = {C050 / C020 / B062 / HD01},
      ddc          = {610},
      cid          = {I:(DE-He78)C050-20160331 / I:(DE-He78)C020-20160331 /
                      I:(DE-He78)B062-20160331 / I:(DE-He78)HD01-20160331},
      pnm          = {313 - Krebsrisikofaktoren und Prävention (POF4-313)},
      pid          = {G:(DE-HGF)POF4-313},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:34239328},
      pmc          = {pmc:PMC8260108},
      doi          = {10.2147/CLEP.S304332},
      url          = {https://inrepo02.dkfz.de/record/169802},
}