Secondary Primary Cancers in Cervical Cancer Survivors: A review

Main Article Content

Tharangrut Hanprasertpong
Jitti Hanprasertpong

Abstract

Cervical cancer (CC) continues to pose a significant global health burden, with human papillomavirus (HPV) infection, smoking, and other factors contributing to its development. Advances in CC screening, vaccination, and treatment have improved survival; however, survivors remain at considerable long-term risk of developing second primary cancers (SPCs), which are associated with substantial morbidity and mortality. Treatments such as radiation and chemotherapy, along with persistent HPV infection and lifestyle factors like tobacco use, further contribute to SPC risk. This review summarizes current evidence on SPCs in CC survivors, focusing on their epidemiology, risk factors, impact on survival, risk assessment, and surveillance strategies.

Article Details

How to Cite
(1)
Hanprasertpong, T. .; Hanprasertpong, J. . Secondary Primary Cancers in Cervical Cancer Survivors: A review. Thai J Obstet Gynaecol 2025, 33, 455-460.
Section
Special Article

References

Hanprasertpong T, Dhanaworavibul K, Leetanaporn K, Hanprasertpong J. Cervical cancer screening in elderly women. Thai J Obstet Gynaecol 2022;30:370-5.

Franco EL, Schlecht NF, Saslow D. The epidemiology of cervical cancer. Cancer J 2003;9:348-59.

Cohen PA, Jhingran A, Oaknin A, Denny L. Cervical cancer. Lancet 2019;393:169-82.

Li Z, Liu P, Yin A, Zhang B, Xu J, Chen Z, et al. Global landscape of cervical cancer incidence and mortality in 2022 and predictions to 2030: The urgent need to address inequalities in cervical cancer. Int J Cancer 2025;157:288-97.

Cao W, Qin K, Li F, Chen W. Comparative study of cancer profiles between 2020 and 2022 using global cancer statistics (GLOBOCAN). J Natl Cancer Cent 2024;4:128-34.

Adjei Boakye E, Grubb L, Peterson CE, Osazuwa-Peters N, Grabosch S, Ladage HD, et al. Risk of second primary cancers among survivors of gynecological cancers. Gynecol Oncol 2020;158:719-26.

Hanprasertpong J, Jiamset I. Late recurrence of early stage cervical cancer more than 3 years after radical hysterectomy with pelvic node dissection. Oncol Res Treat 2017;40:270-6.

Janmunee N, Tangkananan A, Thongkhao P, Hanprasertpong J. Late recurrence of locally advanced cervical cancer treated with concurrent chemoradiotherapy. Oncol Clin Pract 2022;18:393-401.

Wood ME, Vogel V, Ng A, Foxhall L, Goodwin P, Travis LB. Second malignant neoplasms: assessment and strategies for risk reduction. J Clin Oncol 2012;30:3734-45.

Akinyemi OA, Abodunrin FO, Andine TF, Elleissy Nasef K, Akinwumi B, Oduwole A, et al. Second malignancies following primary cervical cancer diagnosis: Analysis of the SEER Database. Cureus 2022;14:e26171.

Chaturvedi AK, Engels EA, Gilbert ES, Chen BE, Storm H, Lynch CF, et al. Second cancers among 104,760 survivors of cervical cancer: evaluation of long-term risk. J Natl Cancer Inst 2007;99:1634-43.

Chen CY, Lai CH, Lee KD, Huang SH, Dai YM, Chen MC. Risk of second primary malignancies in women with cervical cancer: a population-based study in Taiwan over a 30-year period. Gynecol Oncol 2012;127:625-30.

Chen M, Pan X, Wang H, Yao D. The risk and latency evaluation of secondary primary malignancies of cervical cancer patients who received radiotherapy: A study based on the SEER database. Front Oncol 2023;12:1054436.

Siegel RL, Kratzer TB, Giaquinto AN, Sung H, Jemal A. Cancer statistics, 2025. CA Cancer J Clin 2025;75:10-45.

Ayhan A, Yalçin OT, Tuncer ZS, Gürgan T, Küçükali T. Synchronous primary malignancies of the female genital tract. Eur J Obstet Gynecol Reprod Biol 1992;45:63-6.

Gong S, Li G, Li D, Liu Y, Wu B. The risk for subsequent primary lung cancer after cervical carcinoma: A quantitative analysis based on 864,627 cases. PLoS One 2024;19:e0305670.

Underwood JM, Rim SH, Fairley TL, Tai E, Stewart SL. Cervical cancer survivors at increased risk of subsequent tobacco-related malignancies, United States 1992-2008. Cancer Causes Control 2012;23:1009-16.

Teng CJ, Huon LK, Hu YW, Yeh CM, Chao Y, Yang MH, et al. Secondary primary malignancy risk in patients with cervical cancer in Taiwan: A nationwide population-based study. Medicine (Baltimore) 2015;94:e1803.

Nitta Y, Murata H, Okonogi N, Murata K, Wakatsuki M, Karasawa K, et al. Secondary cancers after carbon-ion radiotherapy and photon beam radiotherapy for uterine cervical cancer: A comparative study. Cancer Med 2022;11:2445-54.

Li R, Zhang Y, Ma B, Tan K, Lynn HS, Wu Z. Survival analysis of second primary malignancies after cervical cancer using a competing risk model: implications for prevention and surveillance. Ann Transl Med 2021;9:239.

Wu Y, Chong Y, Han C, Kang K, Liu Z, Zhang F. Second primary malignancies associated with radiation therapy in cervical cancer patients diagnosed between 1975 and 2011: a population-based competing-risk study. Ann Transl Med 2021;9:1375.

Xie N, Lin J, Liu L, Deng S, Yu H, Sun Y. Nomograms constructed for predicting diagnosis and prognosis in cervical cancer patients with second primary malignancies: a SEER database analysis. J Cancer Res Clin Oncol 2023;149:13201-10.

Leetanaporn K, Hanprasertpong J. Addition of chemotherapy to radiation is associated with improved survival in older patients with cervical cancer: a Surveillance, Epidemiology, and End Results database analysis. Int J Gynecol Cancer 2025;35:101633.

Mukherjee D, Coates PJ, Lorimore SA, Wright EG. Responses to ionizing radiation mediated by inflammatory mechanisms. J Pathol 2014;232:289-99.

Kayser S, Döhner K, Krauter J, Köhne CH, Horst HA, Held G, et al. The impact of therapy-related acute myeloid leukemia (AML) on outcome in 2853 adult patients with newly diagnosed AML. Blood 2011;117:2137-45.

Nasioudis D, Lontos K, Tsagianni A, Boyiadzis M, Ko EM. Acute myeloid leukemia following gynecologic cancer in the era of platinum-based chemotherapy. Int J Gynecol Cancer 2018;28:1639-42.

de Martel C, Ferlay J, Franceschi S, Vignat J, Bray F, Forman D, et al. Global burden of cancers attributable to infections in 2008: a review and synthetic analysis. Lancet Oncol. 2012;13:607-15.

Huang K, Xu L, Jia M, Liu W, Wang S, Han J, et al. Second primary malignancies in cervical cancer and endometrial cancer survivors: a population-based analysis. Aging (Albany NY) 2022;14:3836-55.

Castle PE. How does tobacco smoke contribute to cervical carcinogenesis? J Virol 2008;82:6084-5

Mayer DK, Carlson J. Smoking patterns in cancer survivors. Nicotine Tob Res 2011;13:34-40.

Lim MC, Won YJ, Lim J, Kim YJ, Seo SS, Kang S, et al. Second primary cancer after diagnosis and treatment of cervical cancer. Cancer Res Treat 2016;48:641-9.

Fung C, Fossa SD, Beard CJ, Travis LB. Second malignant neoplasms in testicular cancer survivors. J Natl Compr Canc Netw 2012;10:545-56.

Woopen H, Sehouli J, Davis A, Lee YC, Cohen PA, Ferrero A, et al. GCIG-Consensus guideline for long-term survivorship in gynecologic Cancer: A position paper from the gynecologic cancer Intergroup (GCIG) symptom benefit committee. Cancer Treat Rev 2022;107:102396.