Open Access Open Badges Research article

The effect of patient characteristics on second primary cancer risk in France

Jérémie Jégu1142*, Marc Colonna143, Laetitia Daubisse-Marliac1445, Brigitte Trétarre146, Olivier Ganry147, Anne-Valérie Guizard148, Simona Bara149, Xavier Troussard1014, Véronique Bouvier1114, Anne-Sophie Woronoff1214 and Michel Velten113142

Author Affiliations

1 Registre des cancers du Bas-Rhin, Laboratoire d’Épidémiologie et de Santé Publique, EA3430, FMTS, Université de Strasbourg, 4 rue Kirschleger, Strasbourg, CEDEX 67085, France

2 Service de santé publique, Hôpitaux Universitaires de Strasbourg, 1 place de l’hôpital, Strasbourg, CEDEX 67091, France

3 Registre des cancers de l’Isère, CHU de Grenoble, Pavillon E BP 217, Grenoble, CEDEX 9 38043, France

4 Registre des cancers du Tarn, 1, rue Lavazière, BP 37, Albi cedex 81001, France

5 Institut Claudius Regaud, 20–24, rue du Pont-Saint-Pierre, Toulouse cedex 31052, France

6 Registre des tumeurs de l’Hérault, Centre de Recherche, 208 rue des Apothicaires, Montpellier, CEDEX 5 34298, France

7 Registre des cancers de la Somme, Service Épidémiologie Hygiène et Santé Publique, CHU Nord, Amiens, CEDEX 1 80054, France

8 Registre général des tumeurs du Calvados, Cancers & Préventions - U 1086 Inserm, Centre François Baclesse, Avenue du Général Harris BP 5026, Caen, CEDEX 05 14076, France

9 Registre des cancers de la Manche, Centre Hospitalier Public du Cotentin, 46 rue du Val de Saire, Cherbourg-Octeville 50102, France

10 Registre des hémopathies malignes de Basse-Normandie, Unité Fonctionnelle Hospitalo-Universitaire n° 0350, Centre Hospitalier Universitaire, Avenue de la Côte de Nacre, Caen, CEDEX 14033, France

11 Registre des tumeurs digestives du Calvados, Cancers & Préventions - U 1086 Inserm, Centre François Baclesse, Avenue du Général Harris BP 5026, Caen, CEDEX 05 14076, France

12 Registre des tumeurs du Doubs et du Territoire de Belfort, EA3181, Centre Hospitalier Régional Universitaire Saint-Jacques, Besançon, CEDEX 25030, France

13 Service d’épidémiologie et de biostatistique, Centre Paul Strauss, 3 rue de la Porte de l’hôpital, Strasbourg, CEDEX 67065, France

14 Francim : Réseau français des registres des cancers, Toulouse F-31073, France

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BMC Cancer 2014, 14:94  doi:10.1186/1471-2407-14-94

Published: 15 February 2014



Although cancer survivors are known to be at greater risk of developing second primary cancer (SPC), SPC incidence estimates in France are thus far lacking. We used a multivariate approach to compute these estimates and analyzed the effect of patient characteristics (gender, age at diagnosis, first cancer site, year of diagnosis and follow-up) on SPC risk.


Data from ten French population-based cancer registries were used to establish a cohort of all patients diagnosed with a first cancer between 1989 and 2004 and followed up until December 31, 2007. The person-year approach was used to estimate standardized incidence ratios (SIRs) and excess absolute risks (EARs) of metachronous SPC. Multivariate Poisson regression models were then used to model SIRs and EARs separately by gender, adjusting for age, year of diagnosis, follow-up and first cancer site.


Among the 289,967 followed-up patients with a first primary cancer, 21,226 developed a SPC. The SIR was of 1.36 (95% CI, 1.35-1.38) and the EAR was of 39.4 excess cancers per 10,000 person-years (95% CI, 37.4-41.3). Among male and female patients, multivariate analyses showed that age, year of diagnosis, follow-up and first cancer site were often independently associated with SIRs and EARs. Moreover, the EAR of SPC remained elevated during patient follow-up.


French cancer survivors face a dramatically increased risk of SPC which is probably related to the high rate of tobacco and alcohol consumption in France. Multivariate modeling of SPC risk will facilitate the construction of a tailored prediction tool to optimize SPC prevention and early detection strategies.

Neoplasms; Second primary; Risk assessment; Multivariate analysis; Registries; France