FaCD Online Syndrome Fact Sheet

Last updated: 28 Mar 2008

Name: Cervical Cancer, Multiple Primary Malignancies in Patients with

Tumor features

anal cancer
cervical cancer
lung/bronchial cancer
oropharyngeal cancer
pancreatic adenocarcinoma
urinary bladder cancer
vaginal cancer

Tumor features (possible)

colorectal cancer
gastric cancer
laryngeal cancer
ovarian cancer (i.e. epithelial origin)
renal cell cancer


Rabkin et al.[1] examined the incidence of second primary cancers occurring after cervical cancer. Data from the Connecticut Tumor Registry for 1935-1988 and eight other US tumor registries for 1973-1988 were used. Women with primary invasive cervical cancer had a relative risk of 4.6 (95% confidence interval (CI) 2.4-8.1) for subsequent invasive anal cancer. Increased relative risks after cervical cancer were also found for cancers of the oral cavity (RR = 2.2), stomach (1.5), rectum (1.4), larynx (3.4), lung (3.0), vagina (5.6), bladder (2.7) and kidney (1.9). Bergfeldt et al.[2] observed elevated risks for subsequent colon and bladder cancer in 5325 Swedish cervical cancer patients. However, Weinberg et al.[3] found no elevated risk for subsequent colorectal cancer in 21,222 cervical cancer patients from the US cancer registry.

In a study of approximately 80,000 patients, compared with the general population, in both radiotherapy and no-radiotherapy groups risks for cancers of the pharynx, genital sites, and rectum/anus, all HPV-related, and smoking-related cancers of the pharynx, trachea/bronchus/lung, pancreas, and urinary bladder were significantly increased. Cervical cancer patients treated with radiotherapy, but not those who did not receive radiotherapy, were at increased risk for all second cancers and cancers at heavily irradiated sites (colon, rectum/anus, urinary bladder, ovary, and genital sites). [4]

General aspects to consider with respect to multiple primary tumors:
- Shared genetic (immune response, metabolic/hormonal/DNA-repair pathways) or non-genetic (chemical carcinogens, radiation, viruses, life-style) risk factors
- Therapy (radiation, chemotherapy, hormonal) related effects
- Possible bias because of increased surveillance and autopsy findings.


[1] Rabkin CS, Biggar RJ, Melbye M, Curtis RE. Second primary cancers following anal and cervical carcinoma: evidence of shared etiologic factors. Am J Epidemiol 1992; 136(1):54-58.
[2] Bergfeldt K, Einhorn S, Rosendahl I, Hall P. Increased risk of second primary malignancies in patients with gynecological cancer. A Swedish record-linkage study. Acta Oncol 1995; 34(6):771-777.
[3] Weinberg DS, Newschaffer CJ, Topham A. Risk for colorectal cancer after gynecologic cancer. Ann Intern Med 1999; 131(3):189-193.
[4] Chaturvedi AK, Engels EA, Gilbert ES, Chen BE, Storm H, Lynch CF, Hall P, Langmark F, Pukkala E, Kaijser M, Andersson M, Fosså SD, Joensuu H, Boice JD, Kleinerman RA, Travis LB. Second cancers among 104,760 survivors of cervical cancer: evaluation of long-term risk. Journal of the National Cancer Institute 2007; 99(21):1634-43.