{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T21:35:02Z","timestamp":1792100102965,"version":"4.4.0"},"reference-count":58,"publisher":"MDPI AG","issue":"24","license":[{"start":{"date-parts":[[2022,12,14]],"date-time":"2022-12-14T00:00:00Z","timestamp":1670976000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Bio &amp; Medical Technology Development Program of the National Research Foundation (NRF) funded by the Korean government (MSIT)","award":["2020M3A9E8024907"],"award-info":[{"award-number":["2020M3A9E8024907"]}]},{"name":"Bio &amp; Medical Technology Development Program of the National Research Foundation (NRF) funded by the Korean government (MSIT)","award":["HR21C1003"],"award-info":[{"award-number":["HR21C1003"]}]},{"name":"Korea Health Technology R&amp;D Project","award":["2020M3A9E8024907"],"award-info":[{"award-number":["2020M3A9E8024907"]}]},{"name":"Korea Health Technology R&amp;D Project","award":["HR21C1003"],"award-info":[{"award-number":["HR21C1003"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Advances in cancer screening and early detection, as well as improvements in surgical techniques and therapeutics, have contributed to decreasing gastric cancer mortality. The number of gastric cancer survivors continues to rise; however, long-term follow-up has revealed an increase in the risk of post-gastrectomy symptoms or other health problems, such as extra-gastric secondary primary cancer (SPC), in these survivors. Therefore, evidence-based screening for new primary cancer is needed in these populations; however, the incidence of SPC varies by country or continent and its characteristics have not been clearly reported. The characteristics of SPC are of increasing interest to both treatment providers and gastric cancer survivors; thus, this literature review explores not only the epidemiology and biology of SPC but also clinical and biological factors that influence its prognosis.<\/jats:p>","DOI":"10.3390\/cancers14246165","type":"journal-article","created":{"date-parts":[[2022,12,14]],"date-time":"2022-12-14T05:27:23Z","timestamp":1670995643000},"page":"6165","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Secondary Primary Cancer after Primary Gastric Cancer: Literature Review and Big Data Analysis Using the Health Insurance Review and Assessment Service (HIRA) Database of Republic of Korea"],"prefix":"10.3390","volume":"14","author":[{"given":"Jeong Ho","family":"Song","sequence":"first","affiliation":[{"name":"Department of Surgery, Ajou University School of Medicine, Suwon 16499, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yeonkyoung","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Surgery, Ajou University School of Medicine, Suwon 16499, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2066-9062","authenticated-orcid":false,"given":"Jaesung","family":"Heo","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Ajou University School of Medicine, Suwon 16499, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8903-0913","authenticated-orcid":false,"given":"Sang-Yong","family":"Son","sequence":"additional","affiliation":[{"name":"Department of Surgery, Ajou University School of Medicine, Suwon 16499, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5435-5363","authenticated-orcid":false,"given":"Hoon","family":"Hur","sequence":"additional","affiliation":[{"name":"Department of Surgery, Ajou University School of Medicine, Suwon 16499, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5615-4162","authenticated-orcid":false,"given":"Sang-Uk","family":"Han","sequence":"additional","affiliation":[{"name":"Department of Surgery, Ajou University School of Medicine, Suwon 16499, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,12,14]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"651","DOI":"10.3346\/jkms.2013.28.5.651","article-title":"Management of cancer survivors in clinical and public health perspectives: Current status and future challenges in korea","volume":"28","author":"Shin","year":"2013","journal-title":"J. Korean Med. Sci."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"160","DOI":"10.5230\/jgc.2022.22.e21","article-title":"Epidemiology of gastric cancer in korea: Trends in incidence and survival based on korea central cancer registry data (1999\u20132019)","volume":"22","author":"Park","year":"2022","journal-title":"J. Gastric Cancer"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1810","DOI":"10.1056\/NEJMoa072252","article-title":"Adjuvant chemotherapy for gastric cancer with s-1, an oral fluoropyrimidine","volume":"357","author":"Sakuramoto","year":"2007","journal-title":"N. Engl. J. Med."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"315","DOI":"10.1016\/S0140-6736(11)61873-4","article-title":"Adjuvant capecitabine and oxaliplatin for gastric cancer after d2 gastrectomy (classic): A phase 3 open-label, randomised controlled trial","volume":"379","author":"Bang","year":"2012","journal-title":"Lancet"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"616","DOI":"10.1016\/S1470-2045(18)30132-3","article-title":"Chemotherapy versus chemoradiotherapy after surgery and preoperative chemotherapy for resectable gastric cancer (critics): An international, open-label, randomised phase 3 trial","volume":"19","author":"Cats","year":"2018","journal-title":"Lancet Oncol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1948","DOI":"10.1016\/S0140-6736(18)32557-1","article-title":"Perioperative chemotherapy with fluorouracil plus leucovorin, oxaliplatin, and docetaxel versus fluorouracil or capecitabine plus cisplatin and epirubicin for locally advanced, resectable gastric or gastro-oesophageal junction adenocarcinoma (flot4): A randomised, phase 2\/3 trial","volume":"393","author":"Homann","year":"2019","journal-title":"Lancet"},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"The Information Committee of the Korean Gastric Cancer Association (2021). Korean gastric cancer association-led nationwide survey on surgically treated gastric cancers in 2019. J. Gastric Cancer, 21, 221\u2013235.","DOI":"10.5230\/jgc.2021.21.e27"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"673","DOI":"10.1093\/jjco\/hyy077","article-title":"Update version of the japanese guidelines for gastric cancer screening","volume":"48","author":"Hamashima","year":"2018","journal-title":"Jpn. J. Clin. Oncol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"206","DOI":"10.1007\/s101200050064","article-title":"The risk of second malignancy after adjuvant chemotherapy for stomach cancer","volume":"2","author":"Takekuni","year":"1999","journal-title":"Gastric Cancer"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"533","DOI":"10.1097\/00004836-200205000-00010","article-title":"Associated primary tumors in patients with gastric cancer","volume":"34","author":"Silva","year":"2002","journal-title":"J. Clin. Gastroenterol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1159\/000072335","article-title":"Features of second primary cancer in patients with gastric cancer","volume":"65","author":"Ikeda","year":"2003","journal-title":"Oncology"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"235","DOI":"10.1002\/bjs.4758","article-title":"Effective follow-up for recurrence or a second primary cancer in patients with early gastric cancer","volume":"92","author":"Ikeda","year":"2005","journal-title":"J. Br. Surg."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"300","DOI":"10.1007\/s00423-004-0525-4","article-title":"Clinicopathological features of gastric carcinoma patients with other primary carcinomas","volume":"390","author":"Park","year":"2005","journal-title":"Langenbecks Arch. Surg."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"2588","DOI":"10.3748\/wjg.v12.i16.2588","article-title":"Gastric cancer patients at high-risk of having synchronous cancer","volume":"12","author":"Lee","year":"2006","journal-title":"World J. Gastroenterol. WJG"},{"key":"ref_15","first-page":"907","article-title":"Multiple malignant primary neoplasms in patients with gatric neoplasms in the health district of le\u00f3n","volume":"98","year":"2006","journal-title":"Rev. Esp. Enferm. Dig."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"981","DOI":"10.3349\/ymj.2007.48.6.981","article-title":"Surgical outcome of synchronous second primary cancer in patients with gastric cancer","volume":"48","author":"Ha","year":"2007","journal-title":"Yonsei Med. J."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"106","DOI":"10.1002\/jso.21027","article-title":"Synchronous and metachronous cancers in patients with gastric cancer","volume":"98","author":"Eom","year":"2008","journal-title":"J. Surg. Oncol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"173","DOI":"10.4143\/crt.2012.44.3.173","article-title":"Metachronous double primary cancer after diagnosis of gastric cancer","volume":"44","author":"Kim","year":"2012","journal-title":"Cancer Res. Treat."},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Kim, C., Chon, H., Kang, B., Kim, K., Jeung, H.C., Chung, H., Noh, S., and Rha, S. (2013). Prediction of metachronous multiple primary cancers following the curative resection of gastric cancer. BMC Cancer, 13.","DOI":"10.1186\/1471-2407-13-394"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"890","DOI":"10.1111\/cas.12433","article-title":"Incidence of multiple primary cancers and interval between first and second primary cancers","volume":"105","author":"Utada","year":"2014","journal-title":"Cancer Sci."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"490","DOI":"10.1007\/s10120-015-0482-3","article-title":"Second primary malignancy risk among patients with gastric cancer: A nationwide population-based study in taiwan","volume":"19","author":"Chen","year":"2016","journal-title":"Gastric Cancer"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"82","DOI":"10.3389\/fonc.2016.00082","article-title":"Second primary malignancies in adults with gastric cancer\u2013a us population-based study","volume":"6","author":"Shah","year":"2016","journal-title":"Front. Oncol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1016\/j.canep.2017.08.007","article-title":"Risk of second primary cancers among patients with a first primary gastric cancer: A population-based study in north portugal","volume":"50","author":"Morais","year":"2017","journal-title":"Cancer Epidemiol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"515","DOI":"10.2147\/CLEP.S304332","article-title":"Second primary cancers after gastric cancer, and gastric cancer as second primary cancer","volume":"13","author":"Zheng","year":"2021","journal-title":"Clin. Epidemiol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"635","DOI":"10.1016\/S0140-6736(20)31288-5","article-title":"Gastric cancer","volume":"396","author":"Smyth","year":"2020","journal-title":"Lancet"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"S66","DOI":"10.1093\/jjco\/hye138","article-title":"Cancer epidemiology and control in taiwan: A brief review","volume":"32","author":"Chen","year":"2002","journal-title":"Jpn. J. Clin. Oncol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1792","DOI":"10.1038\/sj.bjc.6601755","article-title":"Do preserved foods increase prostate cancer risk?","volume":"90","author":"Jian","year":"2004","journal-title":"Br. J. Cancer"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"497","DOI":"10.1158\/1940-6207.CAPR-21-0509","article-title":"Associations between preserved foods and breast cancer risk in hong kong chinese women","volume":"15","author":"Lee","year":"2022","journal-title":"Cancer Prev. Res."},{"key":"ref_29","first-page":"164","article-title":"Salt-preserved foods and risk of gastric cancer","volume":"42","author":"Strumylaite","year":"2006","journal-title":"Medicina"},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"George, E.S., Sood, S., Broughton, A., Cogan, G., Hickey, M., Chan, W.S., Sudan, S., and Nicoll, A.J. (2021). The association between diet and hepatocellular carcinoma: A systematic review. Nutrients, 13.","DOI":"10.3390\/nu13010172"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"358","DOI":"10.1002\/(SICI)1097-0215(20000201)85:3<358::AID-IJC11>3.0.CO;2-E","article-title":"Preserved foods in relation to risk of nasopharyngeal carcinoma in shanghai, china","volume":"85","author":"Yuan","year":"2000","journal-title":"Int. J. Cancer"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1157","DOI":"10.1007\/s10552-013-0195-z","article-title":"Consumption of fruit, vegetables, and other food groups and the risk of nasopharyngeal carcinoma","volume":"24","author":"Polesel","year":"2013","journal-title":"Cancer Causes Control"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"388","DOI":"10.1093\/annonc\/mdl387","article-title":"Dietary intake of fruit and vegetable and lung cancer risk: A case-control study in harbin, northeast china","volume":"18","author":"Galeone","year":"2007","journal-title":"Ann. Oncol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1031","DOI":"10.1053\/j.gastro.2014.08.005","article-title":"Increased intake of vegetables, but not fruit, reduces risk for hepatocellular carcinoma: A meta-analysis","volume":"147","author":"Yang","year":"2014","journal-title":"Gastroenterology"},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Elhalawani, H., Mohamed, A.S.R., Elgohari, B., Lin, T.A., Sikora, A.G., Lai, S.Y., Abusaif, A., Phan, J., Morrison, W.H., and Gunn, G.B. (2020). Tobacco exposure as a major modifier of oncologic outcomes in human papillomavirus (hpv) associated oropharyngeal squamous cell carcinoma. BMC Cancer, 20.","DOI":"10.1186\/s12885-020-07427-7"},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Chang, C.M., Corey, C.G., Rostron, B.L., and Apelberg, B.J. (2015). Systematic review of cigar smoking and all cause and smoking related mortality. BMC Public Health, 15.","DOI":"10.1186\/s12889-015-1617-5"},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Park, S., Jee, S.H., Shin, H.R., Park, E.H., Shin, A., Jung, K.W., Hwang, S.S., Cha, E.S., Yun, Y.H., and Park, S.K. (2014). Attributable fraction of tobacco smoking on cancer using population-based nationwide cancer incidence and mortality data in korea. BMC Cancer, 14.","DOI":"10.1186\/1471-2407-14-406"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"360","DOI":"10.1053\/j.gastro.2017.08.023","article-title":"Epidemiology of esophageal squamous cell carcinoma","volume":"154","author":"Abnet","year":"2018","journal-title":"Gastroenterology"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"7682387","DOI":"10.1155\/2016\/7682387","article-title":"Smoking exposure and survival of patients with esophagus cancer: A systematic review and meta-analysis","volume":"2016","author":"Kuang","year":"2016","journal-title":"Gastroenterol. Res. Pract."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"239","DOI":"10.2478\/v10019-010-0048-2","article-title":"Second primary cancers in patients with gastric cancer","volume":"44","author":"Buyukasik","year":"2010","journal-title":"Radiol. Oncol."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"322","DOI":"10.1093\/ije\/dyg090","article-title":"Textbook of cancer epidemiology.: Hans-olov adami, david hunter, dimitrios trichopoulos (eds). New york: Oxford university press, inc., 2002, pp. 624, $75.00, \u00a349.50 (hb) isbn: 0-19-510969-4","volume":"32","author":"Schottenfeld","year":"2003","journal-title":"Int. J. Epidemiol."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"480","DOI":"10.1002\/ijc.20293","article-title":"Synergistic effect of alcohol drinking and smoking on in vivo acetaldehyde concentration in saliva","volume":"111","author":"Salaspuro","year":"2004","journal-title":"Int. J. Cancer"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"321","DOI":"10.1093\/mutage\/gem020","article-title":"Leukaemia-specific chromosome damage detected by comet with fluorescence in situ hybridization (comet-fish)","volume":"22","author":"Escobar","year":"2007","journal-title":"Mutagenesis"},{"key":"ref_44","first-page":"69","article-title":"Multiple primary malignancies--epidemiological analysis at a single tertiary institution","volume":"19","author":"Irimie","year":"2010","journal-title":"J. Gastrointestin Liver Dis."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"1","DOI":"10.4132\/jptm.2015.09.10","article-title":"Molecular dimensions of gastric cancer: Translational and clinical perspectives","volume":"50","author":"Choi","year":"2016","journal-title":"J. Pathol. Trans. Med."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"13255","DOI":"10.1073\/pnas.231326898","article-title":"Frameshift-mutation-derived peptides as tumor-specific antigens in inherited and spontaneous colorectal cancer","volume":"98","author":"Saeterdal","year":"2001","journal-title":"Proc. Natl. Acad. Sci. USA"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1186\/s12935-019-1091-8","article-title":"Microsatellite instability: A review of what the oncologist should know","volume":"20","author":"Li","year":"2020","journal-title":"Cancer Cell Int."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"283","DOI":"10.1007\/s10120-020-01113-0","article-title":"Gastric cancer is highly prevalent in lynch syndrome patients with atrophic gastritis","volume":"24","author":"Cho","year":"2021","journal-title":"Gastric Cancer"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"2304","DOI":"10.1001\/jama.2011.743","article-title":"Cancer risks associated with germline mutations in mlh1, msh2, and msh6 genes in lynch syndrome","volume":"305","author":"Bonadona","year":"2011","journal-title":"JAMA"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"444","DOI":"10.1002\/ijc.23508","article-title":"The risk of extra-colonic, extra-endometrial cancer in the lynch syndrome","volume":"123","author":"Watson","year":"2008","journal-title":"Int. J. Cancer"},{"key":"ref_51","first-page":"1358","article-title":"Multiple primary malignant tumors. A survey of the literature and a statistical study","volume":"16","author":"Warren","year":"1932","journal-title":"Am. J. Cancer"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"762","DOI":"10.1111\/j.1349-7006.1991.tb02700.x","article-title":"Second primary cancer after diagnosis of stomach cancer in osaka, japan","volume":"82","author":"Hiyama","year":"1991","journal-title":"Jpn. J. Cancer Res."},{"key":"ref_53","unstructured":"Curtis, R.E., Freedman, D.M., Ron, E., Ries, L.A.G., Hacker, D.G., Edwards, B.K., Tucker, M.A., and Fraumeni, J.F. (2006). New Malignancies among Cancer Survivors: Seer Cancer Registries, 1973\u20132000, National Cancer Institute, National Institutes of Health."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1080\/07357900701208733","article-title":"Carcinogenic food contaminants","volume":"25","author":"Abnet","year":"2007","journal-title":"Cancer Investig."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"247","DOI":"10.1007\/s12029-016-9845-1","article-title":"A review on dietary and non-dietary risk factors associated with gastrointestinal cancer","volume":"47","author":"Urooj","year":"2016","journal-title":"J. Gastrointest. Cancer"},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"2765","DOI":"10.1001\/jama.2008.839","article-title":"Smoking and colorectal cancer: A meta-analysis","volume":"300","author":"Botteri","year":"2008","journal-title":"JAMA"},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"1330","DOI":"10.1016\/j.ejca.2014.01.029","article-title":"Worldwide trends in gastric cancer mortality (1980\u20132011), with predictions to 2015, and incidence by subtype","volume":"50","author":"Ferro","year":"2014","journal-title":"Eur. J. Cancer"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"3734","DOI":"10.1200\/JCO.2012.41.8681","article-title":"Second malignant neoplasms: Assessment and strategies for risk reduction","volume":"30","author":"Wood","year":"2012","journal-title":"J. Clin. Oncol."}],"container-title":["Cancers"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6694\/14\/24\/6165\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:41:08Z","timestamp":1760146868000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6694\/14\/24\/6165"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,12,14]]},"references-count":58,"journal-issue":{"issue":"24","published-online":{"date-parts":[[2022,12]]}},"alternative-id":["cancers14246165"],"URL":"https:\/\/doi.org\/10.3390\/cancers14246165","relation":{},"ISSN":["2072-6694"],"issn-type":[{"value":"2072-6694","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,12,14]]}}}