Table 5.
Anatomic sites at elevated risks of SPMN* according to site of index potentially HPV-associated cancer, Women, SEER 2000–2015.
| Site of index potentially HPV-associated cancer | Site of SPMN | Observed SPMN | SIR 95 % CI | EAR per 10000 PYR |
|---|---|---|---|---|
| All women potentially HPV-associated cancer | ||||
| Non-HPV-associated SPMN | ||||
| Lung and Bronchus | 888 | 2.73 (2.55, 2.91) | 16.82 | |
| Tongue | 87 | 7.58 (6.07, 9.35) | 2.26 | |
| Kidney and Renal Pelvis | 123 | 1.83 (1.52, 2.19) | 1.67 | |
| Thyroid | 147 | 1.49 (1.25, 1.75) | 1.44 | |
| Colorectal | 217 | 1.22 (1.06, 1.39) | 1.17 | |
| Esophagus | 50 | 4.29 (3.18, 5.66) | 1.15 | |
| Pharynx | 34 | 7.22 (5.00, 10.09) | 0.88 | |
| Soft Tissue including Heart | 44 | 2.97 (2.16, 3.99) | 0.87 | |
| Liver | 49 | 2.17 (1.60, 2.86) | 0.79 | |
| Acute Myeloid Leukemia | 43 | 2.32 (1.68, 3.12) | 0.73 | |
| Larynx | 29 | 3.56 (2.38, 5.11) | 0.62 | |
| Stomach | 53 | 1.59 (1.19, 2.08) | 0.59 | |
| Floor of Mouth | 17 | 7.85 (4.57, 12.56) | 0.44 | |
| Hypopharynx | 16 | 10.19 (5.82, 16.54) | 0.43 | |
| HPV-associated SPMN | ||||
| Vulva | 409 | 26.76 (24.23, 29.48) | 11.78 | |
| Vagina | 171 | 36.36 (31.11, 42.23) | 4.98 | |
| Cervical | 144 | 3.36 (2.83, 3.95) | 3.02 | |
| Anal | 73 | 1.56 (1.22, 1.96) | 0.78 | |
| Tonsil | 18 | 4.03 (2.39, 6.37) | 0.41 | |
| Oropharynx | 12 | 9.93 (5.13, 17.35) | 0.32 | |
| Oropharynx | ||||
| Non-HPV-associated SPMN | ||||
| Lung and Bronchus | 189 | 4.36 (3.76, 5.02) | 53.90 | |
| Tongue | 76 | 55.68 (43.87,69.69) | 27.62 | |
| Esophagus | 33 | 22.66 (15.59, 31.82) | 11.68 | |
| Pharynx | 23 | 44.93 (28.47, 67.42) | 8.32 | |
| Larynx | 17 | 16.94 (9.86, 27.12) | 5.92 | |
| Floor of Mouth | 14 | 51.34 (28.01, 86.14) | 5.08 | |
| Liver | 9 | 3.41 (1.56, 6.48) | 2.36 | |
| Nasopharynx | 4 | 23.66 (6.37, 60.59) | 1.42 | |
| Soft Tissue including Heart | 5 | 3.19 (1.03, 7.45) | 1.27 | |
| HPV-associated SPMN | ||||
| Vulvar | 4 | 2.22 (0.60, 5.68) | 0.81 | |
| Cervical | 5 | 1.53 (0.49, 3.56) | 0.64 | |
| Vaginal | 2 | 3.64 (0.41, 13.13) | 0.54 | |
| Anal | 4 | 0.77 (0.21, 1.98) | −0.44 | |
| Penile | NA | NA | NA | |
| Anal | ||||
| Non-HPV-associated SPMN | ||||
| Soft Tissue including Heart | 3 | 8.15 (1.64, 23.81) | 4.40 | |
| HPV-associated SPMN | ||||
| Vaginal | 3 | 22.63 (4.55, 66.11) | 4.79 | |
| Vulva | 2 | 4.59 (0.52, 16.58) | 2.61 | |
| Cervix Uteri | 2 | 2.74 (0.31, 9.89) | 2.12 | |
| Oropharynx | 0 | 0.00 (0.00, 107.21) | −0.06 | |
| Penile | NA | NA | NA | |
| Cervical | ||||
| Non-HPV-associated SPMN | ||||
| Lung and Bronchus | 478 | 2.49 (2.27, 2.72) | 11.23 | |
| Urinary Bladder | 101 | 3.22 (2.62, 3.92) | 2.73 | |
| Thyroid | 117 | 1.53 (1.27, 1.84) | 1.60 | |
| Kidney and Renal Pelvis | 77 | 1.79 (1.41, 2.24) | 1.33 | |
| Ovary | 76 | 1.52 (1.20, 1.90) | 1.02 | |
| Colorectal | 131 | 1.24 (1.03, 1.47) | 0.99 | |
| HPV-associated SPMN | ||||
| Vaginal | 122 | 41.32 (34.31, 49.33) | 4.67 | |
| Vulva | 45 | 4.80 (3.50, 6.43) | 1.40 | |
| Anal | 50 | 1.63 (1.21, 2.14) | 0.76 | |
| Oropharynx | 3 | 3.88 (0.78, 11.33) | 0.09 | |
| Penile | NA | NA | NA | |
| Vulvar | ||||
| Non-HPV-associated SPMN | ||||
| Lung and Bronchus | 178 | 2.66 (2.28, 3.08) | 28.30 | |
| Kidney and Renal Pelvis | 26 | 2.20 (1.44, 3.22) | 3.62 | |
| Liver | 9 | 2.24 (1.02, 4.25) | 1.27 | |
| Soft Tissue including Heart | 7 | 2.84 (1.14, 5.84) | 1.16 | |
| Tongue | 6 | 2.97 (1.08, 6.47) | 1.02 | |
| HPV-associated SPMN | ||||
| Vagina | 29 | 32.54 (21.79, 46.74) | 7.17 | |
| Cervix Uteri | 16 | 3.42 (1.95, 5.56) | 2.89 | |
| Anal | 9 | 1.10 (0.50, 2.09) | 0.21 | |
| Oropharynx | 1 | 4.70 (0.06, 26.17) | 0.20 | |
| Penile | NA | NA | NA | |
| Vaginal | ||||
| Non-HPV-associated SPMN | ||||
| Lung and Bronchus | 29 | 2.19 (1.47, 3.15) | 21.74 | |
| Colorectal | 14 | 1.84 (1.01, 3.09) | 8.82 | |
| HPV-associated SPMN | ||||
| Vulva | 22 | 37.98 (23.79, 57.50) | 29.55 | |
| Cervix Uteri | 3 | 3.38 (0.68, 9.86) | 2.91 | |
| Oropharynx | 0 | 0.00 (0.00, 88.37) | −0.06 | |
| Anal | 1 | 0.62 (0.01, 3.47) | −0.83 | |
| Penile | NA | NA | NA | |
SPMN = Second primary malignant neoplasm; SEER = Surveillance, Epidemiology, and End Results; SIR = Standardized incidence ratio; EAR = Excess absolute risk; PYR = Person-year at risk; CI = Confidence interval.
*
Only non-HPV-associated SPMNs with statistically significant risk are shown (full list of SPMNs are shown in supplemental data).