Influence of Residential Environment and Lifestyle on Multiple Primary Malignancies in Taiwan

  • Chang, Chih-Chun (Department of Clinical Pathology, Far Eastern Memorial Hospital) ;
  • Chung, Yi-Hua (Department of Clinical Pathology, Far Eastern Memorial Hospital) ;
  • Liou, Ching-Biau (Department of Clinical Pathology, Far Eastern Memorial Hospital) ;
  • Lee, Yi-Chen (Department of Clinical Pathology, Far Eastern Memorial Hospital) ;
  • Weng, Wei-Ling (Department of Clinical Pathology, Far Eastern Memorial Hospital) ;
  • Yu, Yun-Chieh (Department of Clinical Pathology, Far Eastern Memorial Hospital) ;
  • Yen, Tzung-Hai (Division of Nephrology and Clinical Toxicology, Chang Gung Memorial Hospital, Lin-Kou Medical Center) ;
  • Wu, Jiann-Ming (Department of General Surgery, Far Eastern Memorial Hospital)
  • Published : 2015.04.29


Background: Multiple primary malignancies (MPM) have become increasingly prevalent worldwide. This investigation was aimed at establishing the clinicopathological characteristics of MPM patients and evaluating the impact of the living environment on MPM in the Taiwanese population. Materials and Methods: From January 2009 to December 2013, a total of 8,268 cancer patients were identified in our institutional center. Of these, 125 were diagnosed as MPM and thus enrolled. Data for clinicopathological features and treatment approaches for these MPM patients living in urban or suburb zone were obtained. Findings for the air pollution status in Taiwan were also collected. Results: The most common cancer match of MPM was esophageal cancer with hypopharyngeal cancer (12.8%), followed by colorectal cancer with gastric cancer (6.4%) and colorectal cancer with breast cancer (5.6%). The air quality was significantly worse in the urban than in the suburban zone and there was a remarkably higher portion of MPM patients in the urban zone suffering from grade III and IV post-chemotherapeutic neutropenia (30.8% vs 15.1%, P=0.036). Conclusions: The tumor frequency and site distribution should be taken into the clinical evaluation because there is a relatively high risk of developing MPM. This study also highlighted the potential influence of environmental factors on post-chemotherapeutic neutropenia for patients with MPM.


Air pollution;lifestyle;multiple primary malignancies;post-chemotherapeutic neutropenia


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