Risk of Second Malignancy in Upper Egypt in the Era of COVID-19: A Multicentric Cancer Experience

Abstract Background: The etiology of second cancer is complex and multifactorial, with the variable burden of second malig-nancy is carried by different types of primary cancers. Aim of Study: In the current study, we evaluated the incidence of second cancers among cancer survivors during the last 3 years following the outbreak of COVID-19 in three cancer treatment centers of Assiut governorate; clinical on-cology department, Assiut Health insurance and south Egypt cancer institute, also their clinicopathologic characteristics and treatment outcomes based on patients' records. Patients and Methods: We recruited all cases presented to the pre-mentioned centers during the period from the start of 2019 to the end of 2021 with confirmed diagnosis of primary and second new cancers. Results: We collected ninety-five cases of second malig-nancies who were still under treatment of their primary tumors, or just under scheduled follow up after finishing their treat-ments, they had a range of age from 3-86 years. 21.1 % had synchronous and 78.9% had metachronous tumors, the median duration for medical treatments of primary tumors was 12 months, no significant differences in age and sex pattern between synchronous and metachronous, 53.7%, and 46.3% had second hematologic and solid tumors respectively, most hematologic second tumors developed earlier than solid ones (p=0.023), there was a female prominence for both primary and second malignant tumors (p=0.01 & <0.001 respectively), the overall control rate for second malignant tumors was 78.8%, and the death rate was 34.7%. Conclusion: Generally, second malignant tumors were not uncommon, their detection had recently increased because of great success in the treatment of primary tumors with prolonged survival and progress in diagnostic and staging modalities. Careful timely surveillance of cancer patients is required especially those who survived COVID-19.