Cancer predisposition syndromes as a risk factor for early second primary neoplasms after childhood cancer - A national cohort study.
Details
Download: Waespe_1-s2.0-S0959804920313794-main.pdf (411.46 [Ko])
State: Public
Version: Final published version
License: CC BY-NC-ND 4.0
State: Public
Version: Final published version
License: CC BY-NC-ND 4.0
Serval ID
serval:BIB_1ED8E884C076
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Cancer predisposition syndromes as a risk factor for early second primary neoplasms after childhood cancer - A national cohort study.
Journal
European journal of cancer
Working group(s)
Swiss Paediatric Oncology Group (SPOG)
Contributor(s)
Ansari M., Beck-Popovic M., Bourquin J.P., Brazzola P., Greiner J., Rössler J., Scheinemann K., Schilling F., von der Weid N.
ISSN
1879-0852 (Electronic)
ISSN-L
0959-8049
Publication state
Published
Issued date
03/2021
Peer-reviewed
Oui
Volume
145
Pages
71-80
Language
english
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't
Publication Status: ppublish
Publication Status: ppublish
Abstract
Childhood cancer patients are at increased risk of second primary neoplasms (SPNs). We assessed incidence and risk factors for early SPNs with a focus on cancer predisposition syndromes (CPSs).
This cohort study used data from the Swiss Childhood Cancer Registry. We included patients with first primary neoplasms (FPNs) diagnosed before age 21 years from 1986 to 2015 and identified SPNs occurring before age 21. We calculated standardised incidence ratios (SIRs) and absolute excess risks (AERs) using Swiss population cancer incidence data, and cumulative incidence of SPNs. We calculated hazard ratios (HRs) of risk factors for SPNs using Fine and Gray competing risk regression.
Among 8074 childhood cancer patients, 304 (4%) were diagnosed with a CPS and 94 (1%) developed early SPNs. The incidence of SPNs was more than 10-fold higher in childhood cancer patients than the incidence of neoplasms in the general population (SIR = 10.6, 95% confidence interval [CI]: 8.7-13.1) and the AER was 179/100,000 person-years (CI: 139-219). Cumulative incidence of SPNs 20 years after FPN diagnosis was 23% in patients with CPSs (CI: 12-41%) and 2.7% in those without (CI: 2.0-3.6%). Risk factors for SPNs were CPSs (HR = 7.8, CI: 4.8-12.7), chemotherapy (HR = 2.2, CI: 1.1-4.6), radiotherapy (HR = 1.9, CI = 1.2-2.9), haematopoietic stem cell transplantation (HR = 1.8, CI: 1-3.3), and older age (15-20 years) at FPN diagnosis (HR = 1.9, CI: 1.1-3.2).
CPSs are associated with a high risk of SPNs before age 21 years. Identification of CPSs is important for appropriate cancer surveillance and targeted screening.
This cohort study used data from the Swiss Childhood Cancer Registry. We included patients with first primary neoplasms (FPNs) diagnosed before age 21 years from 1986 to 2015 and identified SPNs occurring before age 21. We calculated standardised incidence ratios (SIRs) and absolute excess risks (AERs) using Swiss population cancer incidence data, and cumulative incidence of SPNs. We calculated hazard ratios (HRs) of risk factors for SPNs using Fine and Gray competing risk regression.
Among 8074 childhood cancer patients, 304 (4%) were diagnosed with a CPS and 94 (1%) developed early SPNs. The incidence of SPNs was more than 10-fold higher in childhood cancer patients than the incidence of neoplasms in the general population (SIR = 10.6, 95% confidence interval [CI]: 8.7-13.1) and the AER was 179/100,000 person-years (CI: 139-219). Cumulative incidence of SPNs 20 years after FPN diagnosis was 23% in patients with CPSs (CI: 12-41%) and 2.7% in those without (CI: 2.0-3.6%). Risk factors for SPNs were CPSs (HR = 7.8, CI: 4.8-12.7), chemotherapy (HR = 2.2, CI: 1.1-4.6), radiotherapy (HR = 1.9, CI = 1.2-2.9), haematopoietic stem cell transplantation (HR = 1.8, CI: 1-3.3), and older age (15-20 years) at FPN diagnosis (HR = 1.9, CI: 1.1-3.2).
CPSs are associated with a high risk of SPNs before age 21 years. Identification of CPSs is important for appropriate cancer surveillance and targeted screening.
Keywords
Adolescent, Age Factors, Antineoplastic Agents/adverse effects, Cancer Survivors, Child, Child, Preschool, Female, Hematopoietic Stem Cell Transplantation/adverse effects, Humans, Incidence, Infant, Infant, Newborn, Male, Neoplasms, Second Primary/diagnosis, Neoplasms, Second Primary/epidemiology, Neoplastic Syndromes, Hereditary/diagnosis, Neoplastic Syndromes, Hereditary/epidemiology, Radiotherapy/adverse effects, Registries, Risk Assessment, Risk Factors, Switzerland/epidemiology, Young Adult, Adolescent medicine, Cancer survivors, Early detection of cancer, Genetic counselling, Genetic testing, Hereditary neoplastic syndromes, Neoplasms, Pediatrics, Second primary neoplasms, Swiss childhood cancer registry
Pubmed
Web of science
Open Access
Yes
Create date
25/01/2021 9:45
Last modification date
30/12/2023 7:09