In the US, the five-year survival rate for breast cancer has reached 91 percent. However, many breast cancer survivors face an increased risk of developing a new cancer—known as a second primary cancer (SPC)—distinct from a recurrence of their original disease. While understanding SPC incidence and survival is critical to long-term management, differences in SPC risk by race and among Asian American subgroups, as well as its impact on survival outcomes, remains understudied.
A study in the Journal of the National Cancer Institute led by Dr. Eunji Choi, assistant professor of population health sciences, Lizi Shao, a recent graduate of the MS in Biostatistics program at Weill Cornell Medicine, and colleagues, found that white and Black breast cancer survivors have the highest risk of developing SPC, followed by Asian Americans, with the lowest risk occurring among Pacific Islanders. When Asian American ethnic subgroups were examined, Chinese American survivors were found to have SPC risk levels comparable to those of white and Black survivors.
The impact of SPC on survival also varied by race and Asian ethnic group. The adverse effects were most pronounced among Pacific Islander survivors, who experienced a 5.85-fold increased risk of mortality compared with survivors without SPC. Elevated mortality risks were also observed among Chinese and Vietnamese survivors, with 5.27-fold and 7.93-fold increases, respectively.
“Heterogeneity in SPC risk and its impact on survival among breast cancer survivors across racial groups highlight the need for more tailored follow-up for SPC early detection and survivorship care in the US. It is also important to better understand the factors that drive these disparities,” said Dr. Choi.
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