Characterization of subsequent cancer risk in childhood cancer survivors

January 01, 0001

Characterization of subsequent cancer risk in childhood cancer survivors

Childhood cancer survivors are at increased risk of subsequent primary neoplasms. However, the specific long-term risks are uncertain. These UK researchers examined long-term risks of subsequent primary neoplasms in survivors of childhood cancer through the British Childhood Cancer Survivor Study. This study is a population-based cohort of survivors of childhood cancer (n=17 981). The researchers calculated standardized incidence ratios (SIRs), absolute excess risks (AERs), and cumulative incidence of various subsequent primary neoplasms.

The researchers found: "After a median follow-up time of 24.3 years (mean = 25.6 years), 1354 subsequent primary neoplasms were ascertained. The most frequently observed being central nervous system (n = 344), nonmelanoma skin cancer (n = 278), digestive (n = 105), genitourinary (n = 100), breast (n = 97), and bone (n = 94). The overall SIR was 4 times more than expected (SIR, 3.9, AER, 16.8 per 10,000 person-years). The AER at older than 40 years was highest for digestive and genitourinary subsequent primary neoplasms (AER, 5.9 and AER, 6.0 per 10 000 person-years, respectively). Thirty-six percent of the total AER was attributable to these 2 subsequent primary neoplasm sites. The cumulative incidence of colorectal cancer for survivors treated with direct abdominopelvic irradiation was 1.4% by age 50 years, comparable with the 1.2% risk in individuals with at least 2 first-degree relatives affected by colorectal cancer."

The researchers concluded: "Among a cohort of British childhood cancer survivors, the greatest excess risk associated with subsequent primary neoplasms at older than 40 years was for digestive and genitourinary neoplasms."

This study provides important information on the risk of subsequent primary cancers in survivors of childhood cancer.

For the full abstract, click here.

JAMA 305(22):2311-2319, 8 June 2011 © 2011 American Medical Association
Long-term Risks of Subsequent Primary Neoplasms Among Survivors of Childhood Cancer. Raoul C. Reulen, Clare Frobisher, David L. Winter, et al.

Category: A. General/Unspecified. Keywords: cancer, neoplasm, childhood, colorectal, genitourinary, population based cohort, journal watch.
Synopsis edited by Dr Paul Schaefer, Toledo, Ohio. Posted on Global Family Doctor 21 June 2011

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.

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