Association of first primary cancer with risk of subsequent primary cancer among survivors of adult-onset cancers in Kentucky and Appalachian Kentucky

Background Appalachia is a region with significant cancer disparities in incidence and mortality compared to Kentucky the United States. However, contribution of these health subsequent primary cancers (SPCs) among survivors adult-onset limited. This study aimed quantify overall type-specific risks SPCs by first (FPC) types, residence sex. Methods retrospective cohort from Cancer Registry included 148,509 individuals aged 20-84 years diagnosed FPCs 2000-2014 (followed until December 31, 2019) survived at least 5 years. Expected numbers SPC were derived rates population; standardized ratio (SIR) those expected general population. Results Among (50.2% women, 27.9% Appalachian), 17,970 cases occurred during 829,530 person-years follow-up (mean, 5.6 years). men, risk developing any was statistically significantly higher for 20 30 FPC as 31 The highest SIR estimated oral (SIR, 2.14 [95% CI, 1.97-2.33] laryngeal 3.62 2.93-4.42], women. Appalachian had increased different site specific when non-Appalachian survivors. both residents 2.50: 95%CI, 2.10-2.95; SIR, 2.02: 95% 1.77-2.03, respectively). Conclusion Kentucky, several types associated greater an SPC, Risk even residents, but not explained smoking related cancers. Cancers comprised substantial proportions all highlight importance ongoing surveillance efforts prevent new