BACKGROUND:Merkel cell carcinoma (MCC) is an aggressive neuroendocrine tumour of the skin that has been associated with a new tumour virus, the MCC polyomavirus. METHODS:To investigate whether MCC may have a shared aetiology with other cancers, we investigated the risk of second cancers after the diagnosis of MCC using the national cancer registries in Denmark, Norway and Sweden. RESULTS:The overall cancer incidence was increased among patients diagnosed with MCC compared with the general population in these countries (79 secondary cancers total, Standardized Incidence Ratio (SIR) 1.38 (95% confidence interval (CI): 1.10-1.72); 49 secondary cancer in females, SIR 1.7 (95% CI: 1.29-2.25); 30 secondary cancers in males and SIR 1.05 (95% CI: 0.73-1.5)). There were significantly increased incidence ratios for non-melanoma skin cancers (34 secondary cancers, SIR 8.35 (95% CI: 5.97-11.68)), melanoma of skin (6 secondary cancers, SIR 4.29 (95% CI: 1.93-9.56)) and laryngeal cancer (2 secondary cancers, SIR 9.51 (95% CI: 2.38-38)). The SIRs for these three cancer sites were also elevated on restricting the follow-up to cancers occurring at least one year after MCC diagnosis. CONCLUSIONS:Patients diagnosed with MCC are at increased risk of a second cancer, particularly, other skin cancers. Conceivable explanations include the impact of increased surveillance of the skin and shared causative factors, for example, ultraviolet light exposure or MCC polyomavirus infection.

译文

背景:默克尔细胞癌(MCC)是一种侵袭性皮肤神经内分泌肿瘤,已与一种新型肿瘤病毒MCC多瘤病毒相关。
方法:为调查MCC是否可能与其他癌症具有共同的病因,我们使用丹麦,挪威和瑞典的国家癌症登记机构,对MCC诊断后的第二次癌症风险进行了调查。
结果:与这些国家/地区的普通人群相比,诊断为MCC的患者的总体癌症发病率有所增加(总计79例继发性癌症,标准发生率(SIR)1.38(95%置信区间(CI):1.10-1.72); 49例继发性女性癌症,SIR 1.7(95%CI:1.29-2.25);男性30例继发性癌症和SIR 1.05(95%CI:0.73-1.5)。非黑色素瘤皮肤癌(34种继发性癌,SIR 8.35(95%CI:5.97-11.68)),皮肤黑素瘤(6种继发性癌,SIR 4.29(95%CI:1.93-9.56))的发生率显着增加。和喉癌(2种继发性癌症,SIR 9.51(95%CI:2.38-38))。通过限制对MCC诊断至少一年后发生的癌症的随访,也提高了这三个癌症部位的SIR。
结论:诊断为MCC的患者罹患第二种癌症,尤其是其他皮肤癌的风险增加。可能的解释包括增加对皮肤的监视以及共同的病因,例如紫外线照射或MCC多瘤病毒感染的影响。

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