Of 1,486,984 new cancers registered in the Czech Cancer Registry in 1976-2005, 290,312 (19.5%) were multiple malignant neoplasms (MMNs), of which there were 65,292 primary and 89,796 subsequent cases in men and 59,970 primary and 75,254 subsequent cases in women. The duplicities were higher in women, and the triplicities and others (3–6 MMNs) were higher in men. The most frequent diagnoses were the primary cancers of skin, gastrointestinal and urinary tract, male genital organs, respiratory tract in men, and cancers of skin, breast, female genital organs, and gastrointestinal tract in women. The analysis of the early and advanced clinical stages shows that the number of subsequent advanced stages increased after primary advanced stages. Their time-age-space distributions visualized maps of MMNs in 14 Czech regions. These results support the improvement of algorithms of dispensary care for the early detection of the subsequent neoplasms. 1. Introduction The health status of the Czech population can be seen as very vulnerable, mainly because of the high risk of cancer especially in younger age. This fact is confirmed by data in Globocan 2008 [1]. Cancer diagnoses are registered since 1959. The IARC criteria are used were for their notificationed since May 1976 by criteria of the IARC. The annual surveys of Health Information and Statistics of the Czech Republic [2] confirmed the continued trend of cancer occurrence, observed in the Czech areas from 1905 [3] and continuously described from 1933 [4]. The cancer incidence increased from 24,471 (254.4/100,000) in 1959 over 35,407 (347.5/100,000) in 1977 to 78,846 (751.5/100,000) in 2009 [2]. In view of new diagnostic and treatment modalities, the prevalence of cancers (ICD-10: C00-97, D00-09) increased from 174,311 (1,682.2/100,000) in 1989 to 461,545 (4,510/100,000) in 2005. Under the conditions of continuous diagnostics, treatment, medical surveillance, and cancer evidence, the survivors can reach in 2015 nearly 317,000 cases in men (of which 33.2% in age 35–64 years) and 434,000 in women (of which 42.6% in age 35–64 years) [5]. The differences between the numbers of cases and numbers of persons indicated the multiple malignant neoplasms (MMNs). After the preliminary report of their trend [6], this paper is another contribution to this issue. 2. Methods The data of MMNs were based on the number of cancers reported to the Czech Cancer Registry between May 1976 and December 2005 and were verified and anonymised up to October 17, 2007. The percentage of multiple cancers of all diagnoses (ICD-10: C00-97,
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