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Second malignancies after childhood noncentral nervous system solid cancer: results from 13 cancer registries

Maule, Milena ; Scelo, Ghislaine ; Pastore, Guido ; Brennan, Paul ; Hemminki, Kari LU ; Olsen, Jorgen H. ; Tracey, Elizabeth ; Pukkala, Eero ; Weiderpass, Elisabete and Brewster, David H. , et al. (2011) In International Journal of Cancer 129(8). p.1940-1952
Abstract
Children diagnosed with noncentral nervous system solid cancers (NCNSSC) experience several adverse late effects, including second malignant neoplasm. The aim of our study was to assess the risk of specific second malignancies after a childhood NCNSSC. Diagnosis and follow-up data on 10,988 cases of NCNSSC in children (0-14 years) were obtained from 13 registries. Standardized incidence ratios (SIRs) with 95% confidence intervals (CI) and cumulative incidence of second malignancies were computed. We observed 175 second malignant neoplasms, yielding a SIR of 4.6, 95% CI: 3.9-5.3. When considering second cancers with at least 10 occurrences, highest relative risks were found for second malignant bone tumors (SIR = 26.4, 16.6-40.0), soft... (More)
Children diagnosed with noncentral nervous system solid cancers (NCNSSC) experience several adverse late effects, including second malignant neoplasm. The aim of our study was to assess the risk of specific second malignancies after a childhood NCNSSC. Diagnosis and follow-up data on 10,988 cases of NCNSSC in children (0-14 years) were obtained from 13 registries. Standardized incidence ratios (SIRs) with 95% confidence intervals (CI) and cumulative incidence of second malignancies were computed. We observed 175 second malignant neoplasms, yielding a SIR of 4.6, 95% CI: 3.9-5.3. When considering second cancers with at least 10 occurrences, highest relative risks were found for second malignant bone tumors (SIR = 26.4, 16.6-40.0), soft tissue sarcomas (SIR = 14.1, 6.7-25.8) and myeloid leukemia (SIR = 12.7, 6.3-22.8). Significant increased risks for all malignancies combined were observed after sympathetic nervous system tumors (SIR = 11.4, 5.2-21.6), retinoblastomas (SIR = 7.3, 5.4-9.8), renal tumors (SIR = 5.7, 3.8-8.0), malignant bone tumors (SIR = 5.6, 3.7-8.2), soft tissue sarcomas (SIR = 4.7, 3.2-6.8), germ-cell, trophoblastic and other gonadal neoplasms (SIR = 2.5, 1.1-4.9), carcinomas and other malignant epithelial neoplasms (SIR = 2.2, 1.4-3.3). The highest risk of a second malignancy of any type occurred 5 to 9 years after NCNSSC (SIR = 9.9, 6.8-13.9). The cumulative incidence of second malignancies 10 years after the first neoplasm was eight times higher among NCNSSC survivors than in the general population, with the absolute difference between observed and expected cumulative incidence still increasing after 50 years of follow-up. Children who survived a NCNSSC experience a large increased risk of developing a new malignancy, even many years after their initial diagnosis. (Less)
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organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
second malignant neoplasm, childhood solid cancer
in
International Journal of Cancer
volume
129
issue
8
pages
1940 - 1952
publisher
John Wiley & Sons Inc.
external identifiers
  • wos:000294224300016
  • scopus:80052021371
  • pmid:21520035
ISSN
0020-7136
DOI
10.1002/ijc.26135
language
English
LU publication?
yes
id
5c69202f-435d-4e63-a3da-862aa0f2b30b (old id 2161341)
date added to LUP
2016-04-01 11:05:00
date last changed
2022-01-26 05:16:20
@article{5c69202f-435d-4e63-a3da-862aa0f2b30b,
  abstract     = {{Children diagnosed with noncentral nervous system solid cancers (NCNSSC) experience several adverse late effects, including second malignant neoplasm. The aim of our study was to assess the risk of specific second malignancies after a childhood NCNSSC. Diagnosis and follow-up data on 10,988 cases of NCNSSC in children (0-14 years) were obtained from 13 registries. Standardized incidence ratios (SIRs) with 95% confidence intervals (CI) and cumulative incidence of second malignancies were computed. We observed 175 second malignant neoplasms, yielding a SIR of 4.6, 95% CI: 3.9-5.3. When considering second cancers with at least 10 occurrences, highest relative risks were found for second malignant bone tumors (SIR = 26.4, 16.6-40.0), soft tissue sarcomas (SIR = 14.1, 6.7-25.8) and myeloid leukemia (SIR = 12.7, 6.3-22.8). Significant increased risks for all malignancies combined were observed after sympathetic nervous system tumors (SIR = 11.4, 5.2-21.6), retinoblastomas (SIR = 7.3, 5.4-9.8), renal tumors (SIR = 5.7, 3.8-8.0), malignant bone tumors (SIR = 5.6, 3.7-8.2), soft tissue sarcomas (SIR = 4.7, 3.2-6.8), germ-cell, trophoblastic and other gonadal neoplasms (SIR = 2.5, 1.1-4.9), carcinomas and other malignant epithelial neoplasms (SIR = 2.2, 1.4-3.3). The highest risk of a second malignancy of any type occurred 5 to 9 years after NCNSSC (SIR = 9.9, 6.8-13.9). The cumulative incidence of second malignancies 10 years after the first neoplasm was eight times higher among NCNSSC survivors than in the general population, with the absolute difference between observed and expected cumulative incidence still increasing after 50 years of follow-up. Children who survived a NCNSSC experience a large increased risk of developing a new malignancy, even many years after their initial diagnosis.}},
  author       = {{Maule, Milena and Scelo, Ghislaine and Pastore, Guido and Brennan, Paul and Hemminki, Kari and Olsen, Jorgen H. and Tracey, Elizabeth and Pukkala, Eero and Weiderpass, Elisabete and Brewster, David H. and Tamaro, Sharon and Chia, Kee-Seng and Pompe-Kirn, Vera and Kliewer, Erich V. and Tonita, Jon M. and Martos, Carmen and Jonasson, Jon G. and Merletti, Franco and Boffetta, Paolo}},
  issn         = {{0020-7136}},
  keywords     = {{second malignant neoplasm; childhood solid cancer}},
  language     = {{eng}},
  number       = {{8}},
  pages        = {{1940--1952}},
  publisher    = {{John Wiley & Sons Inc.}},
  series       = {{International Journal of Cancer}},
  title        = {{Second malignancies after childhood noncentral nervous system solid cancer: results from 13 cancer registries}},
  url          = {{http://dx.doi.org/10.1002/ijc.26135}},
  doi          = {{10.1002/ijc.26135}},
  volume       = {{129}},
  year         = {{2011}},
}