Screening for second primary tumors in the aerodigestive tract in non-Asian populations with head and neck cancer – systematic review and meta-analysis

Background: Patients diagnosed with a primary tumor in the esophagus, lungs, or head and neck are at an increased risk for developing second primary tumors (SPTs) in these regions. Most studies on SPT prevalence focus on Asian populations, with limited data available for non-Asian groups, leaving th...

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Main Authors: A.D.I. Maan, S.E.M. van de Ven, S. Keereweer, R. Cornelissen, P.D. Siersema, A.D. Koch
Format: Article
Language:English
Published: Elsevier 2025-06-01
Series:ESMO Gastrointestinal Oncology
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Online Access:http://www.sciencedirect.com/science/article/pii/S2949819825000366
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author A.D.I. Maan
S.E.M. van de Ven
S. Keereweer
R. Cornelissen
P.D. Siersema
A.D. Koch
author_facet A.D.I. Maan
S.E.M. van de Ven
S. Keereweer
R. Cornelissen
P.D. Siersema
A.D. Koch
author_sort A.D.I. Maan
collection DOAJ
description Background: Patients diagnosed with a primary tumor in the esophagus, lungs, or head and neck are at an increased risk for developing second primary tumors (SPTs) in these regions. Most studies on SPT prevalence focus on Asian populations, with limited data available for non-Asian groups, leaving the utility of screening unclear. This review aims to assess the yield of screening for SPTs in non-Asian populations following a primary tumor in these regions. Patients and methods: A systematic literature search was conducted to identify studies on screening for esophageal, lung, or head and neck SPTs after a primary tumor diagnosis in any of these sites. The primary outcome was the prevalence by screening of all diagnosed SPTs in the esophagus, head and neck or lungs. Results: Due to limited data on screening for SPTs after esophageal or lung tumors, this review focused solely on screening after primary head and neck tumors. A total of 26 studies with 8071 patients from non-Asian countries were included. The pooled prevalence for all SPTs was 5.4% [95% confidence interval (CI) 4.1% to 7.2%]. The pooled prevalence for esophageal SPTs individually was 5.3% (95% CI 3.7% to 7.7%), for head and neck SPTs 4.6% (95% CI 1.0% to 18.1%) and for lung SPTs 4.0% (95% CI 2.6% to 6.2%). Most SPTs were detected in combination with an index hypopharynx carcinoma (60.0%). The proportion of synchronous (45.3%) and metachronous (54.7%) SPTs was similar. Conclusion: Endoscopic screening for esophageal SPTs in non-Asian countries should be considered, especially in patients with a primary hypopharynx carcinoma.
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spelling doaj-art-610f456d8b4b40aaa29a11f05009a3782025-08-20T03:21:32ZengElsevierESMO Gastrointestinal Oncology2949-81982025-06-01810016710.1016/j.esmogo.2025.100167Screening for second primary tumors in the aerodigestive tract in non-Asian populations with head and neck cancer – systematic review and meta-analysisA.D.I. Maan0S.E.M. van de Ven1S. Keereweer2R. Cornelissen3P.D. Siersema4A.D. Koch5Department of Gastroenterology and Hepatology, Erasmus MC Cancer Institute, University Medical Center, Rotterdam, The Netherlands; Correspondence to: Dr Annemijn D. I. Maan, Department of Gastroenterology and Hepatology, Erasmus MC Cancer Institute, University Medical Center, Dr. Molewaterplein 40, 3015 GD, Rotterdam, The Netherlands. Tel: +316-50033984Department of Gastroenterology and Hepatology, Erasmus MC Cancer Institute, University Medical Center, Rotterdam, The NetherlandsDepartment of Otolaryngology-Head and Neck Surgery, Erasmus MC Cancer Institute, University Medical Center, Rotterdam, The NetherlandsDepartment of Pulmonology, Erasmus MC Cancer Institute, University Medical Center, Rotterdam, The NetherlandsDepartment of Gastroenterology and Hepatology, Erasmus MC Cancer Institute, University Medical Center, Rotterdam, The NetherlandsDepartment of Gastroenterology and Hepatology, Erasmus MC Cancer Institute, University Medical Center, Rotterdam, The NetherlandsBackground: Patients diagnosed with a primary tumor in the esophagus, lungs, or head and neck are at an increased risk for developing second primary tumors (SPTs) in these regions. Most studies on SPT prevalence focus on Asian populations, with limited data available for non-Asian groups, leaving the utility of screening unclear. This review aims to assess the yield of screening for SPTs in non-Asian populations following a primary tumor in these regions. Patients and methods: A systematic literature search was conducted to identify studies on screening for esophageal, lung, or head and neck SPTs after a primary tumor diagnosis in any of these sites. The primary outcome was the prevalence by screening of all diagnosed SPTs in the esophagus, head and neck or lungs. Results: Due to limited data on screening for SPTs after esophageal or lung tumors, this review focused solely on screening after primary head and neck tumors. A total of 26 studies with 8071 patients from non-Asian countries were included. The pooled prevalence for all SPTs was 5.4% [95% confidence interval (CI) 4.1% to 7.2%]. The pooled prevalence for esophageal SPTs individually was 5.3% (95% CI 3.7% to 7.7%), for head and neck SPTs 4.6% (95% CI 1.0% to 18.1%) and for lung SPTs 4.0% (95% CI 2.6% to 6.2%). Most SPTs were detected in combination with an index hypopharynx carcinoma (60.0%). The proportion of synchronous (45.3%) and metachronous (54.7%) SPTs was similar. Conclusion: Endoscopic screening for esophageal SPTs in non-Asian countries should be considered, especially in patients with a primary hypopharynx carcinoma.http://www.sciencedirect.com/science/article/pii/S2949819825000366second primary tumorscreeningesophageal cancerhead and neck cancerlung cancer
spellingShingle A.D.I. Maan
S.E.M. van de Ven
S. Keereweer
R. Cornelissen
P.D. Siersema
A.D. Koch
Screening for second primary tumors in the aerodigestive tract in non-Asian populations with head and neck cancer – systematic review and meta-analysis
ESMO Gastrointestinal Oncology
second primary tumor
screening
esophageal cancer
head and neck cancer
lung cancer
title Screening for second primary tumors in the aerodigestive tract in non-Asian populations with head and neck cancer – systematic review and meta-analysis
title_full Screening for second primary tumors in the aerodigestive tract in non-Asian populations with head and neck cancer – systematic review and meta-analysis
title_fullStr Screening for second primary tumors in the aerodigestive tract in non-Asian populations with head and neck cancer – systematic review and meta-analysis
title_full_unstemmed Screening for second primary tumors in the aerodigestive tract in non-Asian populations with head and neck cancer – systematic review and meta-analysis
title_short Screening for second primary tumors in the aerodigestive tract in non-Asian populations with head and neck cancer – systematic review and meta-analysis
title_sort screening for second primary tumors in the aerodigestive tract in non asian populations with head and neck cancer systematic review and meta analysis
topic second primary tumor
screening
esophageal cancer
head and neck cancer
lung cancer
url http://www.sciencedirect.com/science/article/pii/S2949819825000366
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