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Research article
Additional Primary Cancers in Veterans Surviving Colorectal Cancer – A Critical Analysis
Maithao Le
Albany Stratton VA Medical Center
Corresponding Author
ORCiD: https://orcid.org/0000-0002-7128-5053
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background
There is evidence that colorectal cancer (CRC) survivors in the general population have a higher incidence of additional primary cancer (APC). In addition, distinct patterns of APC have been seen in survivors with right side colon cancer (RCC) versus those with left side colon and rectal cancer (LCRC). These findings may not be representative for veterans surviving colorectal cancer.
Methods
Retrospective chart review was done for 1540 veterans treated for sporadic CRC between July 1995 and December 2011 at three major Veteran Affairs Medical Centers. Sex, war period served, age and pathological stage at diagnosis, tumor laterality, and site/organs of APCs were collected.
Results
99% of our cohort were male. The average age of CRC surviving veterans was 70 as compared to 68 reported in the general population. 27.4% of our cohort had at least one APC as compared to less than 12% reported for the general population. CRC surviving veterans with one or two APCs were older than those without APC (71.2 or 72.5 respectively vs 69.4). The incident of APC was highest in Korean War veterans (27.8%), followed by World War II veterans (24.8%), and Vietnam War veterans (15.9%). Veterans with RCC were older than those with LCRC (71.7 vs 68.8). They also had a higher incidence of APC (32. 9% vs 22.9%). This difference remained unchanged after the cohorts were aged matched (32.9% vs 25.5%). There were more Lynch syndrome related APCs in veterans with RCC that veterans with LCRC (9.6% vs 6.4%). However, this difference did not remain statistically significant in the age-matched cohorts.
Conclusion
More than one in four veterans surviving CRC had APC. Veterans with APC were older, more likely to be Korean War or World War II veterans. There were distinct differences between veterans surviving RCC versus LCRC.
Keywords
additional primary cancer, veterans, right colon cancer, left colon and rectal cancer
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This is a preprint. It has not completed peer review.
Research article
Additional Primary Cancers in Veterans Surviving Colorectal Cancer – A Critical Analysis
Maithao Le
Albany Stratton VA Medical Center
Corresponding Author
ORCiD: https://orcid.org/0000-0002-7128-5053
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
History
CURRENT STATUS: Posted
Version 1
Posted 10 Jul, 2020
No community comments so far
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background
There is evidence that colorectal cancer (CRC) survivors in the general population have a higher incidence of additional primary cancer (APC). In addition, distinct patterns of APC have been seen in survivors with right side colon cancer (RCC) versus those with left side colon and rectal cancer (LCRC). These findings may not be representative for veterans surviving colorectal cancer.
Methods
Retrospective chart review was done for 1540 veterans treated for sporadic CRC between July 1995 and December 2011 at three major Veteran Affairs Medical Centers. Sex, war period served, age and pathological stage at diagnosis, tumor laterality, and site/organs of APCs were collected.
Results
99% of our cohort were male. The average age of CRC surviving veterans was 70 as compared to 68 reported in the general population. 27.4% of our cohort had at least one APC as compared to less than 12% reported for the general population. CRC surviving veterans with one or two APCs were older than those without APC (71.2 or 72.5 respectively vs 69.4). The incident of APC was highest in Korean War veterans (27.8%), followed by World War II veterans (24.8%), and Vietnam War veterans (15.9%). Veterans with RCC were older than those with LCRC (71.7 vs 68.8). They also had a higher incidence of APC (32. 9% vs 22.9%). This difference remained unchanged after the cohorts were aged matched (32.9% vs 25.5%). There were more Lynch syndrome related APCs in veterans with RCC that veterans with LCRC (9.6% vs 6.4%). However, this difference did not remain statistically significant in the age-matched cohorts.
Conclusion
More than one in four veterans surviving CRC had APC. Veterans with APC were older, more likely to be Korean War or World War II veterans. There were distinct differences between veterans surviving RCC versus LCRC.