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HOME > Ann Coloproctol > Volume 30(1); 2014 > Article
Editorial
 Second Primary Cancers Following Colorectal Cancer
Jung Wook Huh
Annals of Coloproctology 2014;30(1):2-2.
DOI: https://doi.org/10.3393/ac.2014.30.1.2
Published online: February 28, 2014

Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

Correspondence to: Jung Wook Huh, M.D. Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 135-710, Korea. Tel: +82-2-3410-1826, Fax: +82-2-3410-6980, jungwook.huh@gmail.com

© 2014 The Korean Society of Coloproctology

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Compared with the general population, individuals with a previous colorectal cancer have an elevated risk of a second primary cancer [1, 2]. Possible reasons for this phenomenon could be (1) an overall greater predisposition to cancer due to the same environmental and genetic factors that contributed to the first primary cancer [3] and (2) the second cancers possibly being related to the effects of treatment for the first cancer [4].
Lynch syndrome is an autosomal, dominant, inherited disorder of cancer susceptibility caused by germline mutations in DNA mismatch repair (MMR) genes. Mutation carriers are prone to developing cancers of the colon, rectum, endometrium, ovary, stomach, small intestine, urinary tract, kidney, biliary tract, and nervous system, and the diagnosis of these cancers generally occurs at a younger age than it does for non-MMR-related cancers [5]. Second cancers following colorectal cancer have essentially two types of patterns: Lynch-syndrome-associated cancers and cancers with no features of Lynch syndrome, which include breast, pancreas, prostate, and thyroid cancers [6-8].
An increased surveillance strategy could lead to earlier identification and removal of both premalignant lesions and early-stage tumors. Any patients diagnosed with colorectal cancer at a young age are at high risk of having a second colorectal cancer and should be followed-up at regular intervals [6]. Furthermore, in surveillance of these patients, all Lynch-syndrome-related sites should be considered. However, given the limited evidence for the efficacy of screening for breast, pancreas, prostate, and thyroid cancers [8, 9], further studies are needed to verify the validity of screening for these cancers in Lynch syndrome.
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  • 5. Umar A, Boland CR, Terdiman JP, Syngal S, de la Chapelle A, Rüschoff J, et al. Revised Bethesda Guidelines for hereditary nonpolyposis colorectal cancer (Lynch syndrome) and microsatellite instability. J Natl Cancer Inst 2004;261–268. ArticlePubMedPMC
  • 6. Hemminki K, Li X, Dong C. Second primary cancers after sporadic and familial colorectal cancer. Cancer Epidemiol Biomarkers Prev 2001;10:793–798. PubMed
  • 7. Lynch HT, de la Chapelle A. Genetic susceptibility to non-polyposis colorectal cancer. J Med Genet 1999;36:801–818. PubMedPMC
  • 8. Win AK, Lindor NM, Young JP, Macrae FA, Young GP, Williamson E, et al. Risks of primary extracolonic cancers following colorectal cancer in lynch syndrome. J Natl Cancer Inst 2012;104:1363–1372. ArticlePubMedPMC
  • 9. Canto MI, Goggins M, Yeo CJ, Griffin C, Axilbund JE, Brune K, et al. Screening for pancreatic neoplasia in high-risk individuals: an EUS-based approach. Clin Gastroenterol Hepatol 2004;2:606–621. ArticlePubMed

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        Second Primary Cancers Following Colorectal Cancer
        Ann Coloproctol. 2014;30(1):2-2.   Published online February 28, 2014
        DOI: https://doi.org/10.3393/ac.2014.30.1.2
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