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Purpose <p>Colorectal cancer (CRC) survivors face an increased risk of multiple primary cancers (MPCs), but evidence on MPC-related mortality is limited.</p> Methods <p>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&#xa0;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.</p> Results <p>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).</p> Conclusions <p>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.</p>

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The risk of mortality from multiple primary cancers in colorectal cancer survivors: analysis of data from the South Australian Cancer Registry

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年7月26日

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  • Mulugeta Melku,
  • Oliver G. Best,
  • Jean M. Winter,
  • Lauren A. Thurgood,
  • Ganessan Kichenadasse,
  • Molla M. Wassie,
  • Muktar Ahmed,
  • Erin L. Symonds

摘要

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.