The risk of mortality from multiple primary cancers in colorectal cancer survivors: analysis of data from the South Australian Cancer Registry
Abstract Purpose Colorectal cancer (CRC) survivors face an increased risk of multiple primary cancers (MPCs), but evidence on MPC-related mortality is limited. Methods Using data from the South Australian Cancer Registry (1982–2017), this retrospective study analysed CRC survivors diagnosed with MPC...
Saved in:
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Springer
2025-07-01
|
| Series: | Journal of Cancer Research and Clinical Oncology |
| Subjects: | |
| Online Access: | https://doi.org/10.1007/s00432-025-06268-w |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849238107522596864 |
|---|---|
| author | Mulugeta Melku Oliver G. Best Jean M. Winter Lauren A. Thurgood Ganessan Kichenadasse Molla M. Wassie Muktar Ahmed Erin L. Symonds |
| author_facet | Mulugeta Melku Oliver G. Best Jean M. Winter Lauren A. Thurgood Ganessan Kichenadasse Molla M. Wassie Muktar Ahmed Erin L. Symonds |
| author_sort | Mulugeta Melku |
| collection | DOAJ |
| description | Abstract Purpose Colorectal cancer (CRC) survivors face an increased risk of multiple primary cancers (MPCs), but evidence on MPC-related mortality is limited. Methods Using data from the South Australian Cancer Registry (1982–2017), this retrospective study analysed CRC survivors diagnosed with MPCs, defined as distinct primary cancers arising ≥ 2 months after CRC diagnosis. Causes of death were categorised as index CRC, MPC, or non-cancer related. Poisson regression estimated cancer-specific mortality risk compared to the general population. Propensity score weighting was applied to balance covariate distribution between CRC survivors with and without MPC groups. A hazard ratio (HR) for all-cause mortality was estimated using a weighted dataset to assess the impact of MPC on overall survival. Results Among 26,093 CRC survivors (181,877 person-years follow-up), the age-standardised MPC-related mortality rate was 240 per 100,000 population. Gastrointestinal, lung, haematological, and urinary tract cancers were the most common MPC-related causes of death. CRC survivors had a 45% higher risk of dying from MPCs than the general population (standardised mortality ratio = 1.45, 95%CI 1.38–1.52). Adjusted analyses showed a 58% increase in all-cause mortality among CRC survivors with MPCs (HR = 1.58, 95%CI 1.51–1.65). Conclusions CRC survivors with MPC face significantly worse survival compared to those with a single primary CRC. Early detection and management of MPCs are essential for improving long-term survival in individuals diagnosed with CRC. |
| format | Article |
| id | doaj-art-b3647074e4cd4b5db31f5a186579e5f4 |
| institution | Kabale University |
| issn | 1432-1335 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Springer |
| record_format | Article |
| series | Journal of Cancer Research and Clinical Oncology |
| spelling | doaj-art-b3647074e4cd4b5db31f5a186579e5f42025-08-20T04:01:44ZengSpringerJournal of Cancer Research and Clinical Oncology1432-13352025-07-01151711110.1007/s00432-025-06268-wThe risk of mortality from multiple primary cancers in colorectal cancer survivors: analysis of data from the South Australian Cancer RegistryMulugeta Melku0Oliver G. Best1Jean M. Winter2Lauren A. Thurgood3Ganessan Kichenadasse4Molla M. Wassie5Muktar Ahmed6Erin L. Symonds7Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders UniversityFlinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders UniversityFlinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders UniversityFlinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders UniversityFlinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders UniversityFlinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders UniversityFlinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders UniversityFlinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders UniversityAbstract Purpose Colorectal cancer (CRC) survivors face an increased risk of multiple primary cancers (MPCs), but evidence on MPC-related mortality is limited. Methods Using data from the South Australian Cancer Registry (1982–2017), this retrospective study analysed CRC survivors diagnosed with MPCs, defined as distinct primary cancers arising ≥ 2 months after CRC diagnosis. Causes of death were categorised as index CRC, MPC, or non-cancer related. Poisson regression estimated cancer-specific mortality risk compared to the general population. Propensity score weighting was applied to balance covariate distribution between CRC survivors with and without MPC groups. A hazard ratio (HR) for all-cause mortality was estimated using a weighted dataset to assess the impact of MPC on overall survival. Results Among 26,093 CRC survivors (181,877 person-years follow-up), the age-standardised MPC-related mortality rate was 240 per 100,000 population. Gastrointestinal, lung, haematological, and urinary tract cancers were the most common MPC-related causes of death. CRC survivors had a 45% higher risk of dying from MPCs than the general population (standardised mortality ratio = 1.45, 95%CI 1.38–1.52). Adjusted analyses showed a 58% increase in all-cause mortality among CRC survivors with MPCs (HR = 1.58, 95%CI 1.51–1.65). Conclusions CRC survivors with MPC face significantly worse survival compared to those with a single primary CRC. Early detection and management of MPCs are essential for improving long-term survival in individuals diagnosed with CRC.https://doi.org/10.1007/s00432-025-06268-wColorectal cancerHazard ratioMortalityMultiple primary cancerStandardised mortality ratio |
| spellingShingle | Mulugeta Melku Oliver G. Best Jean M. Winter Lauren A. Thurgood Ganessan Kichenadasse Molla M. Wassie Muktar Ahmed Erin L. Symonds The risk of mortality from multiple primary cancers in colorectal cancer survivors: analysis of data from the South Australian Cancer Registry Journal of Cancer Research and Clinical Oncology Colorectal cancer Hazard ratio Mortality Multiple primary cancer Standardised mortality ratio |
| title | The risk of mortality from multiple primary cancers in colorectal cancer survivors: analysis of data from the South Australian Cancer Registry |
| title_full | The risk of mortality from multiple primary cancers in colorectal cancer survivors: analysis of data from the South Australian Cancer Registry |
| title_fullStr | The risk of mortality from multiple primary cancers in colorectal cancer survivors: analysis of data from the South Australian Cancer Registry |
| title_full_unstemmed | The risk of mortality from multiple primary cancers in colorectal cancer survivors: analysis of data from the South Australian Cancer Registry |
| title_short | The risk of mortality from multiple primary cancers in colorectal cancer survivors: analysis of data from the South Australian Cancer Registry |
| title_sort | risk of mortality from multiple primary cancers in colorectal cancer survivors analysis of data from the south australian cancer registry |
| topic | Colorectal cancer Hazard ratio Mortality Multiple primary cancer Standardised mortality ratio |
| url | https://doi.org/10.1007/s00432-025-06268-w |
| work_keys_str_mv | AT mulugetamelku theriskofmortalityfrommultipleprimarycancersincolorectalcancersurvivorsanalysisofdatafromthesouthaustraliancancerregistry AT olivergbest theriskofmortalityfrommultipleprimarycancersincolorectalcancersurvivorsanalysisofdatafromthesouthaustraliancancerregistry AT jeanmwinter theriskofmortalityfrommultipleprimarycancersincolorectalcancersurvivorsanalysisofdatafromthesouthaustraliancancerregistry AT laurenathurgood theriskofmortalityfrommultipleprimarycancersincolorectalcancersurvivorsanalysisofdatafromthesouthaustraliancancerregistry AT ganessankichenadasse theriskofmortalityfrommultipleprimarycancersincolorectalcancersurvivorsanalysisofdatafromthesouthaustraliancancerregistry AT mollamwassie theriskofmortalityfrommultipleprimarycancersincolorectalcancersurvivorsanalysisofdatafromthesouthaustraliancancerregistry AT muktarahmed theriskofmortalityfrommultipleprimarycancersincolorectalcancersurvivorsanalysisofdatafromthesouthaustraliancancerregistry AT erinlsymonds theriskofmortalityfrommultipleprimarycancersincolorectalcancersurvivorsanalysisofdatafromthesouthaustraliancancerregistry AT mulugetamelku riskofmortalityfrommultipleprimarycancersincolorectalcancersurvivorsanalysisofdatafromthesouthaustraliancancerregistry AT olivergbest riskofmortalityfrommultipleprimarycancersincolorectalcancersurvivorsanalysisofdatafromthesouthaustraliancancerregistry AT jeanmwinter riskofmortalityfrommultipleprimarycancersincolorectalcancersurvivorsanalysisofdatafromthesouthaustraliancancerregistry AT laurenathurgood riskofmortalityfrommultipleprimarycancersincolorectalcancersurvivorsanalysisofdatafromthesouthaustraliancancerregistry AT ganessankichenadasse riskofmortalityfrommultipleprimarycancersincolorectalcancersurvivorsanalysisofdatafromthesouthaustraliancancerregistry AT mollamwassie riskofmortalityfrommultipleprimarycancersincolorectalcancersurvivorsanalysisofdatafromthesouthaustraliancancerregistry AT muktarahmed riskofmortalityfrommultipleprimarycancersincolorectalcancersurvivorsanalysisofdatafromthesouthaustraliancancerregistry AT erinlsymonds riskofmortalityfrommultipleprimarycancersincolorectalcancersurvivorsanalysisofdatafromthesouthaustraliancancerregistry |