TY - JOUR
T1 - Risk of subsequent neoplasms during the fifth and sixth decades of life in the childhood cancer survivor study cohort
AU - Turcotte, Lucie M.
AU - Whitton, John A.
AU - Friedman, Debra L.
AU - Hammond, Sue
AU - Armstrong, Gregory T.
AU - Leisenring, Wendy
AU - Robison, Leslie L.
AU - Neglia, Joseph P.
N1 - Publisher Copyright:
© 2015 American Society of Clinical Oncology. All rights reserved.
PY - 2015/11/1
Y1 - 2015/11/1
N2 - Purpose: Survivors of childhood cancer have an increased risk for subsequent neoplasms (SNs), but the ncidence beyond the age of 40 years and associations with therapeutic exposures have not been well described Patients and Methods: Among 14,364 survivors of childhood cancer diagnosed between 1970 and 1986, 3,171 had an attained age of 40 years or older at the time of last contact. Cumulative incidence of SNs, standardized incidence ratios (SIRs), excess absolute risk of subsequent malignant neoplasms (SMNs), and relative risks (RRs) for SMNs and nonmelanoma skin cancers were calculated Results: In total, 679 SNs were diagnosed in patients age 40 years or older. These included 196 SMNs, 419 nonmelanoma skin cancers, 21 nonmalignant meningiomas, and 43 other benign neoplasms. At age 55 years, the cumulative incidence of new SNs and SMNs occurring after age 40 years was 34.6% (95% CI, 28.7 to 40.6) and 16.3% (95% CI, 11.7 to 20.9), respectively. Survivors were twice as likely as the general population to receive a diagnosis of SMN after age 40 years (SIR, 2.2; 95% CI, 1.9 to 2.5). Among SMNs, risk was increased for breast cancer (SIR, 5.5; 95% CI, 4.5 to 6.7), renal cancer (SIR, 3.9; 95% CI, 2.0 to 7.5), soft tissue sarcoma (SIR, 2.6; 95% CI, 1.5 to 4.4), and thyroid cancer (SIR, 1.9; 95% CI, 1.0 to 3.5). Female sex (RR, 1.9; 95% CI, 1.3 to 2.6; P< .001) and therapeutic radiation exposure (RR, 2.2; 95% CI, 1.4 to 3.3; P< .001) were associated with an increased for risk for SMN in multivariable analysis. Conclusion: Even after age 40 years, survivors of childhood cancer remain at increased risk for treatment-related SNs. These data suggest the need for life-long monitoring and should inform anticipatory guidance provided to survivors of childhood cancer.
AB - Purpose: Survivors of childhood cancer have an increased risk for subsequent neoplasms (SNs), but the ncidence beyond the age of 40 years and associations with therapeutic exposures have not been well described Patients and Methods: Among 14,364 survivors of childhood cancer diagnosed between 1970 and 1986, 3,171 had an attained age of 40 years or older at the time of last contact. Cumulative incidence of SNs, standardized incidence ratios (SIRs), excess absolute risk of subsequent malignant neoplasms (SMNs), and relative risks (RRs) for SMNs and nonmelanoma skin cancers were calculated Results: In total, 679 SNs were diagnosed in patients age 40 years or older. These included 196 SMNs, 419 nonmelanoma skin cancers, 21 nonmalignant meningiomas, and 43 other benign neoplasms. At age 55 years, the cumulative incidence of new SNs and SMNs occurring after age 40 years was 34.6% (95% CI, 28.7 to 40.6) and 16.3% (95% CI, 11.7 to 20.9), respectively. Survivors were twice as likely as the general population to receive a diagnosis of SMN after age 40 years (SIR, 2.2; 95% CI, 1.9 to 2.5). Among SMNs, risk was increased for breast cancer (SIR, 5.5; 95% CI, 4.5 to 6.7), renal cancer (SIR, 3.9; 95% CI, 2.0 to 7.5), soft tissue sarcoma (SIR, 2.6; 95% CI, 1.5 to 4.4), and thyroid cancer (SIR, 1.9; 95% CI, 1.0 to 3.5). Female sex (RR, 1.9; 95% CI, 1.3 to 2.6; P< .001) and therapeutic radiation exposure (RR, 2.2; 95% CI, 1.4 to 3.3; P< .001) were associated with an increased for risk for SMN in multivariable analysis. Conclusion: Even after age 40 years, survivors of childhood cancer remain at increased risk for treatment-related SNs. These data suggest the need for life-long monitoring and should inform anticipatory guidance provided to survivors of childhood cancer.
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U2 - 10.1200/JCO.2015.60.9487
DO - 10.1200/JCO.2015.60.9487
M3 - Article
C2 - 26261260
AN - SCOPUS:84947242835
SN - 0732-183X
VL - 33
SP - 3568
EP - 3575
JO - Journal of Clinical Oncology
JF - Journal of Clinical Oncology
IS - 31
ER -