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      author       = {G. Zheng$^*$ and K. Sundquist and J. Sundquist and T. Chen
                      and A. Försti$^*$ and A. Hemminki and V. Liska and K.
      title        = {{S}econd {P}rimary {C}ancers {A}fter {L}iver, {G}allbladder
                      and {B}ile {D}uct {C}ancers, and {T}hese {C}ancers as
                      {S}econd {P}rimary {C}ancers.},
      journal      = {Clinical epidemiology},
      volume       = {13},
      issn         = {1179-1349},
      address      = {Albany, Auckland},
      publisher    = {Dove Medical Press},
      reportid     = {DKFZ-2021-01815},
      pages        = {683 - 691},
      year         = {2021},
      note         = {#EA:C020#},
      abstract     = {Second primary cancers (SPCs) are important clinically as
                      they may negatively influence patient survival and they may
                      tell about therapeutic side effects and general causes of
                      cancer. Population-based literature concerning SPCs after
                      hepatobiliary cancers is limited and here we assess risks of
                      SPCs after hepatocellular cancer (HCC), and cancers of the
                      gallbladder, bile ducts and ampulla of Vater. In reverse
                      order, we consider the risk of hepatobiliary cancers as SPCs
                      after any cancer.We used standardized incidence ratios
                      (SIRs) to estimate bidirectional relative risks of
                      subsequent cancers associated with hepatobiliary cancers.
                      Cancer diagnoses were obtained from the Swedish Cancer
                      Registry from years 1990 through 2015.We identified 9997
                      primary HCCs, 1365 gallbladder cancers and 4721 bile duct
                      cancers. After HCC, risks of four SPCs were increased:
                      gallbladder (SIR = 4.38; $95\%$ confidence interval
                      1.87-8.67), thyroid (4.13; 1.30-9.70), kidney (2.92;
                      1.66-4.47) and squamous cell skin (1.55; 1.02-2.26) cancers.
                      In reverse order, HCC as SPC, in addition to the above
                      cancers, associations included upper aerodigestive tract,
                      esophageal, small intestinal and bladder cancers and
                      non-Hodgkin lymphoma. For gallbladder and bile duct cancers,
                      associations were found with small intestinal and pancreatic
                      cancers.The results suggested that HCC is associated with
                      two types of SPC, one related to shared environmental risk
                      factors, such as alcohol, exemplified by upper aerodigestive
                      tract and esophageal cancer, and the other related to immune
                      dysfunction, exemplified by squamous cell skin cancer. SPCs
                      associated with gallbladder and bile duct cancers suggest
                      predisposition to mutations in the mismatch repair gene
      keywords     = {cancer etiology (Other) / cancer incidence (Other) /
                      hepatobiliary cancer (Other) / relative risk (Other) /
                      second primary 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:34377034},
      pmc          = {pmc:PMC8349530},
      doi          = {10.2147/CLEP.S318737},
      url          = {https://inrepo02.dkfz.de/record/170192},