TY - JOUR
T1 - Time from incident primary cancer until recurrence or second primary cancer
T2 - Risk factors and impact in general practice
AU - Rasmussen, Linda Aagaard
AU - Jensen, Henry
AU - Virgilsen, Line Flytkjær
AU - Falborg, Alina Zalounina
AU - Møller, Henrik
AU - Vedsted, Peter
N1 - Publisher Copyright:
© 2019 John Wiley & Sons Ltd
Copyright:
Copyright 2019 Elsevier B.V., All rights reserved.
PY - 2019/9/1
Y1 - 2019/9/1
N2 - Objective: Specialised follow-up care after cancer treatment is changing towards increased involvement of general practice. To ensure timely detection of new cancer events, knowledge is warranted on the timing of cancer recurrence (CR) and second primary cancer (SPC), including risk factors for CR. Methods: This population-based register study included 67,092 patients diagnosed with malignant melanoma, bladder, lung, ovarian, endometrial, colorectal and breast cancer in Denmark in 2008–2016. The time from primary cancer to CR or SPC and risk factors for prolonged time to CR were analysed and stratified on sex and primary cancer type. Results: Cancer recurrence proportions ranged from 6% to 35%. The risk of CR increased profoundly within the first 3 years and then levelled off, except for breast cancer. A total of 3%–6% of patients had SPC, with monotonously increasing cumulative incidence proportions. Besides primary tumour characteristics, lower educational level, living alone and comorbidity were associated with earlier CR. For example, in female malignant melanoma, HRs and 95% confidence intervals were 0.47 (0.37–0.61) for high educational level, 1.40 (1.16–1.68) for living alone and 2.38 (1.53–3.70) for high comorbidity. Conclusion: The results may inform stratified risk assessment in decision of frequency, location and duration of post-cancer follow-up care.
AB - Objective: Specialised follow-up care after cancer treatment is changing towards increased involvement of general practice. To ensure timely detection of new cancer events, knowledge is warranted on the timing of cancer recurrence (CR) and second primary cancer (SPC), including risk factors for CR. Methods: This population-based register study included 67,092 patients diagnosed with malignant melanoma, bladder, lung, ovarian, endometrial, colorectal and breast cancer in Denmark in 2008–2016. The time from primary cancer to CR or SPC and risk factors for prolonged time to CR were analysed and stratified on sex and primary cancer type. Results: Cancer recurrence proportions ranged from 6% to 35%. The risk of CR increased profoundly within the first 3 years and then levelled off, except for breast cancer. A total of 3%–6% of patients had SPC, with monotonously increasing cumulative incidence proportions. Besides primary tumour characteristics, lower educational level, living alone and comorbidity were associated with earlier CR. For example, in female malignant melanoma, HRs and 95% confidence intervals were 0.47 (0.37–0.61) for high educational level, 1.40 (1.16–1.68) for living alone and 2.38 (1.53–3.70) for high comorbidity. Conclusion: The results may inform stratified risk assessment in decision of frequency, location and duration of post-cancer follow-up care.
KW - cancer survivors
KW - care transition
KW - primary health care
KW - recurrence
KW - second primary neoplasms
UR - http://www.scopus.com/inward/record.url?scp=85068042856&partnerID=8YFLogxK
U2 - 10.1111/ecc.13123
DO - 10.1111/ecc.13123
M3 - Journal article
C2 - 31231898
AN - SCOPUS:85068042856
SN - 0961-5423
VL - 28
JO - European Journal of Cancer Care
JF - European Journal of Cancer Care
IS - 5
M1 - e13123
ER -