© 2002 by Oxford University Press
Journal of the National Cancer Institute, Vol. 94, No. 7, 529-530,
April 3, 2002
© 2002 Oxford University Press
CORRESPONDENCE |
RESPONSE:Re: Effect of Age on Risk of Second Primary Colorectal Cancer
Affiliations of authors: I. Shureiqi (Departments of Clinical Cancer Prevention and Gastrointestinal Medical Oncology), A. S. Soliman (Department of Epidemiology), S. M. Lippman (Department of Clinical Cancer Prevention), The University of Texas M. D. Anderson Cancer Center, Houston.
Correspondence to: Scott M. Lippman, M.D., Dept. of Clinical Cancer Prevention, M. D. Anderson Cancer Center, 1515 Holcombe Blvd., Box 236, Houston, TX 77030 (e-mail: slippman{at}mdanderson.org).
The very informative correspondence of Dr. Levi and his colleagues provides further confirmation of the striking inverse correlation between age at diagnosis of a first colorectal primary cancer and the risk of a colorectal second primary tumor (1,2). Consistent studies in three very large cohorts—ours in the United States (1), one in Sweden (2), and now another in Switzerland—validate the finding that younger age at the time of colorectal primary cancer diagnosis predicts a significantly increased risk for a colorectal second primary tumor. The Swedish cohort data (2) showed that the inverse correlation between age and risk of colorectal second primary cancer was more evident in sporadic colorectal cancer cases than in familial cases, whose high risk remains fairly constant across age groups. Furthermore, the majority of the Swedish familial cases did not have hereditary nonpolyposis colorectal cancer (2). These data support the need for increased surveillance for colorectal second primary tumors in younger sporadic cancer patients (notwithstanding the absence of a family history of colorectal cancers) (1). These younger patients also should be encouraged to participate in colorectal cancer chemoprevention studies (1). Of course surveillance in familial cases is necessarily high at any age. These findings substantiate our initial hypothesis that young patients' increased risk of colorectal second primary tumors is related to biologic phenomena that are independent of the currently known familial cancer syndromes. Clearly, further studies are warranted to identify the molecular basis of increased second primary tumor risk of young colorectal cancer patients.
REFERENCES
1
Shureiqi I, Cooksley CD, Morris J, Soliman AS, Levin B, Lippman SM. Effect of age on risk of second primary colorectal cancer. J Natl Cancer Inst 2001;93:1264–6.
2
Hemminki K, Li X, Dong C. Second primary cancers after sporadic and familial colorectal cancer. Cancer Epidemiol Biomarkers Prev 2001;10:793–8.
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