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Risk of a second malignant neoplasm among 5-year survivors of cancer in childhood and adolescence in British Columbia, Canada.
Pediatr Blood Cancer 2007; 48(4):453-9PB

Abstract

BACKGROUND

We examined second malignancies, a recognized late effect of therapy among survivors of childhood and adolescent cancer, among a recent, population-based cohort of 2,322 5-year survivors diagnosed before 20 years of age in British Columbia (BC), Canada between 1970 and 1995.

PROCEDURE

Survivors and second malignancies were identified from the BC Cancer Registry. Risk of second malignancy was evaluated using standardized incidence ratios (SIRs), absolute excess risk (AER), and cumulative risk. The effect of demographic, temporal, and disease-related characteristics on risk was assessed.

RESULTS

Fifty-five second malignancies were observed after 26,071 person-years of follow-up. Relative rate of developing a second malignancy among survivors was 5 times higher than expected (SIR = 5.0, 95% CI, 3.8-6.5), and absolute excess risk was 1.7 deaths per 1,000 person-years. Cumulative incidence of a second malignancy was 5.1% at 25 years after diagnosis of the first cancer. SIRs and absolute excess risk of subsequent cancer was higher among females (SIR = 5.9, 95% CI, 4.5-8.3 and AER = 2.66). While relative risk of second cancer was higher for those diagnosed before 10 years of age (SIR = 10.6, 95% CI, 7.1-16.0), absolute excess risk was slightly higher for those diagnosed after 10 years of age. SIRs were significantly elevated for all follow-up periods, but absolute excess risk of a second cancer was highest among patients surviving more than 15 years.

CONCLUSIONS

Increased risk of a subsequent neoplasm is evident among childhood cancer survivors diagnosed in more recent periods than has been previously reported, continues years after diagnosis, and varies according to several risk factors. Continued surveillance is essential to quantify and characterize long-term and changing risks for appropriate follow-up.

Authors+Show Affiliations

Cancer Control Research Program, British Columbia Cancer Agency, Vancouver, British Columbia, Canada.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

16767718

Citation

MacArthur, Amy C., et al. "Risk of a Second Malignant Neoplasm Among 5-year Survivors of Cancer in Childhood and Adolescence in British Columbia, Canada." Pediatric Blood & Cancer, vol. 48, no. 4, 2007, pp. 453-9.
MacArthur AC, Spinelli JJ, Rogers PC, et al. Risk of a second malignant neoplasm among 5-year survivors of cancer in childhood and adolescence in British Columbia, Canada. Pediatr Blood Cancer. 2007;48(4):453-9.
MacArthur, A. C., Spinelli, J. J., Rogers, P. C., Goddard, K. J., Phillips, N., & McBride, M. L. (2007). Risk of a second malignant neoplasm among 5-year survivors of cancer in childhood and adolescence in British Columbia, Canada. Pediatric Blood & Cancer, 48(4), pp. 453-9.
MacArthur AC, et al. Risk of a Second Malignant Neoplasm Among 5-year Survivors of Cancer in Childhood and Adolescence in British Columbia, Canada. Pediatr Blood Cancer. 2007;48(4):453-9. PubMed PMID: 16767718.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Risk of a second malignant neoplasm among 5-year survivors of cancer in childhood and adolescence in British Columbia, Canada. AU - MacArthur,Amy C, AU - Spinelli,John J, AU - Rogers,Paul C, AU - Goddard,Karen J, AU - Phillips,Norm, AU - McBride,Mary L, PY - 2006/6/13/pubmed PY - 2007/4/28/medline PY - 2006/6/13/entrez SP - 453 EP - 9 JF - Pediatric blood & cancer JO - Pediatr Blood Cancer VL - 48 IS - 4 N2 - BACKGROUND: We examined second malignancies, a recognized late effect of therapy among survivors of childhood and adolescent cancer, among a recent, population-based cohort of 2,322 5-year survivors diagnosed before 20 years of age in British Columbia (BC), Canada between 1970 and 1995. PROCEDURE: Survivors and second malignancies were identified from the BC Cancer Registry. Risk of second malignancy was evaluated using standardized incidence ratios (SIRs), absolute excess risk (AER), and cumulative risk. The effect of demographic, temporal, and disease-related characteristics on risk was assessed. RESULTS: Fifty-five second malignancies were observed after 26,071 person-years of follow-up. Relative rate of developing a second malignancy among survivors was 5 times higher than expected (SIR = 5.0, 95% CI, 3.8-6.5), and absolute excess risk was 1.7 deaths per 1,000 person-years. Cumulative incidence of a second malignancy was 5.1% at 25 years after diagnosis of the first cancer. SIRs and absolute excess risk of subsequent cancer was higher among females (SIR = 5.9, 95% CI, 4.5-8.3 and AER = 2.66). While relative risk of second cancer was higher for those diagnosed before 10 years of age (SIR = 10.6, 95% CI, 7.1-16.0), absolute excess risk was slightly higher for those diagnosed after 10 years of age. SIRs were significantly elevated for all follow-up periods, but absolute excess risk of a second cancer was highest among patients surviving more than 15 years. CONCLUSIONS: Increased risk of a subsequent neoplasm is evident among childhood cancer survivors diagnosed in more recent periods than has been previously reported, continues years after diagnosis, and varies according to several risk factors. Continued surveillance is essential to quantify and characterize long-term and changing risks for appropriate follow-up. SN - 1545-5009 UR - https://www.unboundmedicine.com/medline/citation/16767718/Risk_of_a_second_malignant_neoplasm_among_5_year_survivors_of_cancer_in_childhood_and_adolescence_in_British_Columbia_Canada_ L2 - https://doi.org/10.1002/pbc.20921 DB - PRIME DP - Unbound Medicine ER -