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Risk of selected subsequent carcinomas in survivors of childhood cancer: a report from the Childhood Cancer Survivor Study.

Abstract

PURPOSE

To determine the risk of subsequent carcinomas other than breast, thyroid, and skin, and to identify factors that influence the risk among survivors of childhood cancer.

PATIENTS AND METHODS

Subsequent malignant neoplasm history was determined in 13,136 participants (surviving > or = 5 years postmalignancy, diagnosed from 1970 to 1986 at age < 21 years) of the Childhood Cancer Survivor Study to calculate standardized incidence ratios (SIRs), using Surveillance, Epidemiology, and End Results data.

RESULTS

In 71 individuals, 71 carcinomas were diagnosed at a median age of 27 years and a median elapsed time of 15 years in the genitourinary system (35%), head and neck area (32%), gastrointestinal tract (23%), and other sites (10%). Fifty-nine patients (83%) had received radiotherapy, and 42 (59%) developed a second malignant neoplasm in a previous radiotherapy field. Risk was significantly elevated following all childhood diagnoses except CNS neoplasms, and was highest following neuroblastoma (SIR = 24.2) and soft tissue sarcoma (SIR = 6.2). Survivors of neuroblastoma had a 329-fold increased risk of renal cell carcinomas; survivors of Hodgkin's lymphoma had a 4.5-fold increased risk of gastrointestinal carcinomas. Significantly elevated risk of head and neck carcinoma occurred in survivors of soft tissue sarcoma (SIR = 22.6), neuroblastoma (SIR = 20.9), and leukemia (SIR = 20.9).

CONCLUSION

Young survivors of childhood cancers are at increased risk of developing subsequent carcinomas typical of later adulthood, underscoring the importance of long-term follow-up and risk-based screening. Follow-up of the cohort is ongoing to determine lifetime risk and delineate individual characteristics that contribute to risk.

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  • Authors+Show Affiliations

    ,

    Division of Pediatric Hematology/Oncology/BMT, University of Colorado Health Sciences Center, Denver, CO, USA.

    , , , , , , , , , , ,

    Source

    MeSH

    Adolescent
    Adult
    Child
    Child, Preschool
    Female
    Gastrointestinal Neoplasms
    Head and Neck Neoplasms
    Humans
    Incidence
    Lung Neoplasms
    Male
    Middle Aged
    Neoplasms
    Neoplasms, Radiation-Induced
    Neoplasms, Second Primary
    Risk Assessment
    SEER Program
    Survivors
    Time Factors
    United States
    Urogenital Neoplasms

    Pub Type(s)

    Journal Article
    Multicenter Study
    Research Support, N.I.H., Extramural
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    16421424

    Citation

    Bassal, Mylène, et al. "Risk of Selected Subsequent Carcinomas in Survivors of Childhood Cancer: a Report From the Childhood Cancer Survivor Study." Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology, vol. 24, no. 3, 2006, pp. 476-83.
    Bassal M, Mertens AC, Taylor L, et al. Risk of selected subsequent carcinomas in survivors of childhood cancer: a report from the Childhood Cancer Survivor Study. J Clin Oncol. 2006;24(3):476-83.
    Bassal, M., Mertens, A. C., Taylor, L., Neglia, J. P., Greffe, B. S., Hammond, S., ... Kadan-Lottick, N. S. (2006). Risk of selected subsequent carcinomas in survivors of childhood cancer: a report from the Childhood Cancer Survivor Study. Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology, 24(3), pp. 476-83.
    Bassal M, et al. Risk of Selected Subsequent Carcinomas in Survivors of Childhood Cancer: a Report From the Childhood Cancer Survivor Study. J Clin Oncol. 2006 Jan 20;24(3):476-83. PubMed PMID: 16421424.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Risk of selected subsequent carcinomas in survivors of childhood cancer: a report from the Childhood Cancer Survivor Study. AU - Bassal,Mylène, AU - Mertens,Ann C, AU - Taylor,Leslie, AU - Neglia,Joseph P, AU - Greffe,Brian S, AU - Hammond,Sue, AU - Ronckers,Cécile M, AU - Friedman,Debra L, AU - Stovall,Marilyn, AU - Yasui,Yutaka Y, AU - Robison,Leslie L, AU - Meadows,Anna T, AU - Kadan-Lottick,Nina S, PY - 2006/1/20/pubmed PY - 2006/2/10/medline PY - 2006/1/20/entrez SP - 476 EP - 83 JF - Journal of clinical oncology : official journal of the American Society of Clinical Oncology JO - J. Clin. Oncol. VL - 24 IS - 3 N2 - PURPOSE: To determine the risk of subsequent carcinomas other than breast, thyroid, and skin, and to identify factors that influence the risk among survivors of childhood cancer. PATIENTS AND METHODS: Subsequent malignant neoplasm history was determined in 13,136 participants (surviving > or = 5 years postmalignancy, diagnosed from 1970 to 1986 at age < 21 years) of the Childhood Cancer Survivor Study to calculate standardized incidence ratios (SIRs), using Surveillance, Epidemiology, and End Results data. RESULTS: In 71 individuals, 71 carcinomas were diagnosed at a median age of 27 years and a median elapsed time of 15 years in the genitourinary system (35%), head and neck area (32%), gastrointestinal tract (23%), and other sites (10%). Fifty-nine patients (83%) had received radiotherapy, and 42 (59%) developed a second malignant neoplasm in a previous radiotherapy field. Risk was significantly elevated following all childhood diagnoses except CNS neoplasms, and was highest following neuroblastoma (SIR = 24.2) and soft tissue sarcoma (SIR = 6.2). Survivors of neuroblastoma had a 329-fold increased risk of renal cell carcinomas; survivors of Hodgkin's lymphoma had a 4.5-fold increased risk of gastrointestinal carcinomas. Significantly elevated risk of head and neck carcinoma occurred in survivors of soft tissue sarcoma (SIR = 22.6), neuroblastoma (SIR = 20.9), and leukemia (SIR = 20.9). CONCLUSION: Young survivors of childhood cancers are at increased risk of developing subsequent carcinomas typical of later adulthood, underscoring the importance of long-term follow-up and risk-based screening. Follow-up of the cohort is ongoing to determine lifetime risk and delineate individual characteristics that contribute to risk. SN - 1527-7755 UR - https://www.unboundmedicine.com/medline/citation/16421424/Risk_of_selected_subsequent_carcinomas_in_survivors_of_childhood_cancer:_a_report_from_the_Childhood_Cancer_Survivor_Study_ L2 - http://ascopubs.org/doi/full/10.1200/JCO.2005.02.7235?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -