† Contributed equally.
The aim of this study was to assess risk factors associated with developing second cancer in premenopausal and postmenopausal endometrial cancer survivors using data from the Surveillance, Epidemiology, and End Results (SEER) database. Multivariate analysis revealed that for both groups age was a risk factor for second cancer development. For premenopausal women, being white versus black, having endometrioid adenocarcinoma compared with other histological types increased the risk of developing a second cancer (p values ≤ 0.018). For postmenopausal women, being Non-Spanish-Hispanic-Latino versus Spanish-Hispanic-Latino, having squamous cell carcinoma versus endometroid adenocarcinoma, N0 compared with N1 nodes, M0 versus M1 metastasis, and no surgery or radiotherapy compared with surgery alone or surgery plus radiotherapy increased the likelihood of developing second cancer (p values ≤ 0.012). The results of Cox proportional hazard analysis indicated that premenopausal and postmenopausal women with endometrial cancer who underwent surgery plus radiotherapy showed the greatest benefit with respect to cause-specific survival (adjusted HR 0.192, 95%CI: 0.135 to 0.274, and adjusted HR 0.206, 95%CI, 0.184 to 0.230, respectively). In summary, risk factors for second cancer in survivors of endometrial cancer differ between premenopausal and postmenopausal women, and suggests that the two groups of women should be managed differently.