{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,20]],"date-time":"2026-03-20T21:22:54Z","timestamp":1774041774375,"version":"3.50.1"},"reference-count":38,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,3,20]],"date-time":"2026-03-20T00:00:00Z","timestamp":1773964800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,3,20]],"date-time":"2026-03-20T00:00:00Z","timestamp":1773964800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100004391","name":"China Medical University Hospital","doi-asserted-by":"publisher","award":["DMR\u2010114\u2010066"],"award-info":[{"award-number":["DMR\u2010114\u2010066"]}],"id":[{"id":"10.13039\/501100004391","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Asia-Pac J Clncl Oncology"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>The incidence of second cancers has increased notably in recent decades, yet a comprehensive understanding of double primary cancers remains elusive. This nationwide retrospective cohort analysis aims to address this gap by providing actionable insights for establishing screening and evaluation protocols in Taiwan.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We integrated data from the Registry for Catastrophic Illness Patient Database and the Taiwan Cancer Registry, focusing on patients diagnosed with specified cancers between 2000 and 2017. Double primary cancers were identified on the basis of International Classification of Diseases for Oncology codes and categorized as synchronous (within 180 days) or metachronous (beyond 180 days). Three cohorts\u2014single primary, synchronous, and metachronous cancers\u2014were compared for their cancer site distributions, stage distributions, relative risks, and survival rates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Key findings revealed that among 1,080,450 patients with initial cancer diagnoses, 45,084 (4.17%) developed second cancers. Among males, those with oral cancer most frequently develop esophageal cancer. In females, breast, colorectal, and lung cancer commonly develop either synchronously or metachronously. Synchronous cancers were often diagnosed at stage IV (first synchronous cancer: 37.2%, second synchronous cancer: 36.0%). Mortality rates for common double cancers were significantly higher than those for single primary cancers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This study provides practical insights into the characteristics and outcomes of double primary cancers. This highlights the critical need for screening and managing second cancers in newly diagnosed cancer patients, especially for synchronous cancers. Visual aids such as pie charts and tables were developed to facilitate clinical recommendations for double cancer screening.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ajco.70105","type":"journal-article","created":{"date-parts":[[2026,3,20]],"date-time":"2026-03-20T19:35:02Z","timestamp":1774035302000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Unveiling the Characteristics and Survival Outcomes of Double Primary Cancers in Taiwan: A Nationwide Population\u2010based Comparison Cohort Study"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7918-0224","authenticated-orcid":false,"given":"Ting\u2010Chun","family":"Lin","sequence":"first","affiliation":[{"name":"Graduate Institute of Biomedical Sciences China Medical University  Taichung Taiwan"},{"name":"Department of Radiation Oncology China Medical University Hospital  Taichung Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chi\u2010Chi","family":"Chan","sequence":"additional","affiliation":[{"name":"Department of General Clinic China Medical University Hospital  Taichung Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hung\u2010Yin","family":"Lai","sequence":"additional","affiliation":[{"name":"Graduate Institute of Biomedical Sciences China Medical University  Taichung Taiwan"},{"name":"Department of Ophthalmology China Medical University Hospital, China Medical University  Taichung Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cheng\u2010Li","family":"Lin","sequence":"additional","affiliation":[{"name":"Management Office for Health Data China Medical University Hospital  Taichung Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chun\u2010Jui","family":"Chang","sequence":"additional","affiliation":[{"name":"Department of Family Medicine Wan Fang Hospital Taipei Medical University  Taipei Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ji\u2010An","family":"Liang","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology China Medical University Hospital  Taichung Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,3,20]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"crossref","first-page":"3029","DOI":"10.1002\/cncr.33587","article-title":"The Ever\u2010increasing Importance of Cancer as a Leading Cause of Premature Death Worldwide","volume":"127","author":"Bray F.","year":"2021","journal-title":"Cancer"},{"key":"e_1_2_11_3_1","first-page":"209","article-title":"Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries","volume":"71","author":"Sung H.","year":"2021","journal-title":"CA: A Cancer Journal for Clinicians"},{"key":"e_1_2_11_4_1","volume-title":"Cancer Registry Annual Report, 2020 Taiwan","author":"Health Promotion Administration","year":"2022"},{"key":"e_1_2_11_5_1","doi-asserted-by":"crossref","DOI":"10.1177\/10732748231176641","article-title":"Research Progress of Multiple Primary Malignancies Associated with Esophageal Cancer","volume":"30","author":"Cui Y.","year":"2023","journal-title":"Cancer Control"},{"key":"e_1_2_11_6_1","doi-asserted-by":"crossref","first-page":"108","DOI":"10.3390\/cancers9080108","article-title":"National and Subnational Population\u2010Based Incidence of Cancer in Thailand: Assessing Cancers With the Highest Burdens","volume":"9","author":"Virani S.","year":"2017","journal-title":"Cancers (Basel)"},{"key":"e_1_2_11_7_1","volume-title":"International Classification of Diseases for Oncology (ICD\u2010O), 3rd ed., 1st revision","author":"World Health Organization","year":"2013"},{"key":"e_1_2_11_8_1","volume-title":"SEER Program Coding and Staging Manual 2021","author":"Adamo M.","year":"2020"},{"key":"e_1_2_11_9_1","first-page":"7","article-title":"Cancer Statistics, 2021","volume":"71","author":"Siegel R. 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