Risk of second malignancies in long-term survivors of childhood cancer

Abstract Introduction Childhood cancer survivors are known to be at increased risk for second malignancies. Patients and methods The risk of second malignancies was assessed in 1368 5-year survivors of childhood cancer treated in the Emma Children’s Hospital AMC in Amsterdam. The median follow-up ti...

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Bibliographic Details
Published in:European journal of cancer (1990) 2007-01, Vol.43 (2), p.351-362
Main Authors: Cardous-Ubbink, M.C, Heinen, R.C, Bakker, P.J.M, van den Berg, H, Oldenburger, F, Caron, H.N, Voûte, P.A, van Leeuwen, F.E
Format: Article
Language:English
Subjects:
Adolescent
Adult
Biological and medical sciences
Cause specific survival
Child
Child, Preschool
Childhood cancer
Cohort Studies
Female
Follow-Up Studies
Hematology, Oncology and Palliative Medicine
Humans
Infant
Infant, Newborn
Long-term side effects
Long-term survival
Male
Medical sciences
Neoplasms, Second Primary - etiology
Neoplasms, Second Primary - mortality
Netherlands - epidemiology
Pharmacology. Drug treatments
Risk Factors
Second malignancies
Survival Analysis
Survivors - statistics & numerical data
Tumors
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Summary:Abstract Introduction Childhood cancer survivors are known to be at increased risk for second malignancies. Patients and methods The risk of second malignancies was assessed in 1368 5-year survivors of childhood cancer treated in the Emma Children’s Hospital AMC in Amsterdam. The median follow-up time was 16.8 years. Results Sixty two malignancies were observed against 5.4 expected, yielding a standardised incidence ratio (SIR) of 11.2 (95% confidence interval: 8.53–14.4; absolute excess risk: 3.2 per 1000 person-years). New observations were the strongly increased risks of meningiomas (SIR = 40) and basal cell carcinomas (SIR = 9). Patients whose treatment involved radiotherapy had a 2-fold increased second cancer risk compared to patients with chemotherapy alone. Discussion The relative risk of second malignancies does not decrease till at least 30 years of follow-up. With aging of the survivor cohort this results in a strong increase of the AER, due to the rising background risk of cancer with age.
ISSN:0959-8049
1879-0852
DOI:10.1016/j.ejca.2006.10.004