Prevalence of Prior Cancer in Patients With Newly Diagnosed Cancer


Key Points

  • Prior cancer was identified in 18% of patients with incident primary cancer.
  • A history of prior cancer was found in 25% of patients aged ≥ 65 years and 11.0% of younger patients.

In a study using Surveillance, Epidemiology, and End Results (SEER) data reported in JAMA Oncology, Murphy et al found that among persons newly diagnosed with cancer, 25% of those aged ≥ 65 years and 11% of those aged < 65 years had a history of a prior primary cancer.

Prevalence of Prior Cancer

The study involved data from 740,990 patients in SEER cancer registries who were newly diagnosed with cancer between January 2009 and December 2013. Of 765,843 incident cancers diagnosed during this period, 141,021 (18.4%) were second-order or higher primary cancers. A history of prior cancer was identified in 25.2% of patients aged ≥ 65 years (who accounted for 400,882 incident cancers) and 11.0% of those aged < 65 years (who accounted for 364,961 incident cancers) with newly diagnosed cancer.

Common Prior Cancers

The prevalence of prior cancer ranged from 3.5% to 36.9%, according to the incident cancer type and age. Among patients aged 20 to 64 years, prior cancer was most common among those with incident myeloid and monocytic leukemias (24.8%); anal, anal canal, and rectal cancers (18.2%); cervical and other female genital organ cancers (15.0%); and lung and other respiratory cancers (14.6%); although prior cancers generally occurred at a different cancer site in this age group, breast, cervical, and other female genital cancers and male genital and testicular cancers were more often in the same site.

Among patients aged ≥ 65 years, prior cancer was most common in patients with incident melanoma (36.9%), myeloid and monocytic leukemias (36.9%), bone and joint cancers (34.0%), and urinary bladder and other urinary organ cancers (32.5%); with the exception of breast cancer and melanoma, most prior cancers occurred at a different site.

The investigators concluded: “A substantial proportion of patients diagnosed with incident cancer in the United States have survived a prior cancer. These patients may be excluded from clinical trials and underrepresented in observational research, and little is known about their treatment and survivorship needs. Understanding the nature and impact of prior cancer is critical to improving clinical trial accrual and generalizability, disease outcomes, and patient experience.”

The study was supported by grants from the National Cancer Institute and the National Center for Advancing Translational Sciences.

Caitlin C. Murphy, PhD, MPH, of the Department of Clinical Sciences, The University of Texas Southwestern Medical Center, is the corresponding author of the JAMA Oncology article.

The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.