{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T00:50:58Z","timestamp":1775523058033,"version":"3.50.1"},"reference-count":24,"publisher":"Wiley","issue":"15","license":[{"start":{"date-parts":[[2021,4,6]],"date-time":"2021-04-06T00:00:00Z","timestamp":1617667200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["acsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2021,8]]},"abstract":"<jats:sec><jats:title>BACKGROUND<\/jats:title><jats:p>Improvements in cancer survival mean that an increasing number of survivors may live long enough beyond their initial cancer to be diagnosed with additional independent primary cancers. The proportion of newly diagnosed cancers that are second\u2010 or higher\u2010order primaries and how this proportion has changed over the past several decades were examined.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>Data from the Surveillance, Epidemiology, and End Results (SEER) program were used to identify incident malignant primaries diagnosed between 1975 and 2017. Using the SEER sequence number, the authors tabulated the proportion of all cancers in each calendar year that were second\u2010 or higher\u2010order primaries. The average annual percent change (AAPC) was then calculated to assess how this proportion has changed over time.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>Analyses included nearly 4.9 million incident cancers diagnosed during 1975\u20102017. The proportion of all cancers that were second\u2010 or higher\u2010order increased steadily from 9.77% during 1975\u20101984 to 21.03% during 2015\u20102017, reflecting an AAPC of 2.41% (95% CI, 2.16%\u20102.65%). In 2015\u20102017, second\u2010 or higher\u2010order cancers were most prevalent among cancers of the bladder (28.79%), followed by lung and bronchus (28.07%), melanoma (27.88%), and leukemia (26.10%). The highest AAPCs over the study period were observed for melanoma (4.05%), leukemia (3.51%), and lung and bronchus (3.36%).<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>The proportion of newly diagnosed cancers that are second\u2010 or higher\u2010order has grown rapidly over the past several decades and currently exceeds 20%. Continued monitoring of second and later primaries will be critical for anticipating the future impact on cancer treatment and survivorship care.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cncr.33558","type":"journal-article","created":{"date-parts":[[2021,4,6]],"date-time":"2021-04-06T18:00:50Z","timestamp":1617732050000},"page":"2736-2742","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Trends in the proportion of second or later primaries among all newly diagnosed malignant cancers"],"prefix":"10.1002","volume":"127","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6535-481X","authenticated-orcid":false,"given":"Chelsea","family":"Anderson","sequence":"first","affiliation":[{"name":"Department of Epidemiology University of North Carolina Chapel Hill North Carolina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Deborah K.","family":"Mayer","sequence":"additional","affiliation":[{"name":"School of Nursing University of North Carolina Chapel Hill North Carolina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0972-1560","authenticated-orcid":false,"given":"Hazel B.","family":"Nichols","sequence":"additional","affiliation":[{"name":"Department of Epidemiology University of North Carolina Chapel Hill North Carolina"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,4,6]]},"reference":[{"key":"e_1_2_8_2_1","volume-title":"Cancer Treatment & Survivorship Facts & Figures 2019\u20102021","author":"American Cancer Society","year":"2019"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.31543"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.4143\/crt.2019.210"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12885-019-6074-6"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.7150\/jca.46584"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/dju302"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11764-020-00872-0"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.26678"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12160-011-9290-0"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1188\/17.ONF.703-711"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.23005"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/pon.3227"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoncol.2017.3605"},{"key":"e_1_2_8_15_1","volume-title":"SEER*Stat Database: Incidence\u2014SEER Research Data, 9 Registries, Nov 2019 Sub (1975\u20102017)\u2014Linked to County Attributes\u2014Time Dependent (1990\u20102017) Income\/Rurality, 1969\u20102018 Counties","author":"Surveillance, Epidemiology, and End Results Program","year":"2020"},{"key":"e_1_2_8_16_1","unstructured":"National Cancer Institute.Division of Cancer Control & Population Sciences. 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