Navigation Links
Childhood cancer survivors at increased risk of certain tumors in middle-age
Date:6/4/2011

In a study that included nearly 18,000 children who had cancer, with follow-up of about 25 years, the greatest excess risk associated with a subsequent primary neoplasm (a new tumor) at older than age 40 years was for digestive and genitourinary neoplasms (related to the genital or urinary tract organs), according to a study in the June 8 issue of JAMA, a theme issue on cancer. The study is being published early online to coincide with the American Society of Clinical Oncology 2011 Annual Meeting.

"Survivors of childhood cancer are at increased risk of developing subsequent primary neoplasms with the risk being estimated at 3- to 6-fold than expected. However, the magnitude of the long-term risks of developing a subsequent primary neoplasm, in particular beyond ages at which the background cancer incidence in the general population starts to increase substantially, are unknown," according to background information in the article. "It is essential to investigate the long-term risks of subsequent primary neoplasms since any increased relative risk (RR) sustained into old age would lead to a substantial number of survivors being diagnosed with a subsequent primary neoplasm. To reduce the number of subsequent primary neoplasms, prevention, screening, and other intervention strategies should focus on subsequent primary neoplasm types with the highest absolute excess risks (AERs); however, it is currently unclear which subsequent primary neoplasm types contribute most to the total AER, particularly at older than 40 years."

Raoul C. Reulen, Ph.D., of the University of Birmingham, Edgbaston, United Kingdom, and colleagues conducted a study to investigate the long-term risks of subsequent primary neoplasms in survivors of childhood cancer. The British Childhood Cancer Survivor Study included 17,981 5-year survivors of childhood cancer diagnosed with cancer at younger than 15 years between 1940 and 1991 in Great Britain, who were followed up through December 2006.

Through the follow-up period, 1,354 subsequent primary neoplasms were diagnosed in 1,222 of the 17,981 survivors in the cohort. The average follow-up time from childhood cancer diagnosis was 25.6 years. The most commonly observed subsequent primary neoplasms were central nervous system tumors (n = 344) of which 105 were gliomas, nonmelanoma skin cancer (n = 278), digestive (n = 105), genitourinary (n = 100), breast (n = 97), and bone (n = 94). Overall, survivors were 4 times more likely to develop a subsequent primary neoplasm than expected. Digestive and genitourinary subsequent primary neoplasms contributed the largest AER at older than 40 years compared with other subsequent primary neoplasm categories; 36 percent of the total AER was attributable to genitourinary and digestive subsequent primary neoplasms. Overall, 52 percent of the total AER was attributable to digestive, genitourinary, breast, or respiratory sites at older than 40 years.

"These increased risks of digestive subsequent primary neoplasms are likely to be related to previous exposure of the digestive tract to radiation, except following heritable retinoblastoma. We found a 3-fold increased RR for survivors treated with direct abdomino-pelvic irradiation. The highest AER for genitourinary subsequent primary neoplasms was observed after heritable retinoblastoma, suggesting that this excess risk is at least partially attributable to genetic predisposition," the authors write.

The cumulative percentage of survivors developing a subsequent primary neoplasm increased steadily with attained age from 1.6 percent at age 20 years to 13.8 percent at age 60 years, whereas 8.4 percent was expected at the latter age based on rates from the general population. Five percent of survivors had developed a subsequent primary neoplasm by age 38 years, whereas it took until age 54 years for 5 percent of a comparable cohort (based on the general population rates) to develop a cancer.

The researchers also found that the cumulative incidence of developing colorectal cancer by age 50 years was 1.4 percent for survivors treated with direct abdomino-pelvic irradiation. This risk is comparable to the equivalent percentage (1.2 percent) for individuals with at least 2 first-degree relatives affected by colorectal cancer. They add that this is, to their knowledge, the first time this finding has been demonstrated. "This raises the question of whether childhood cancer survivors treated with direct abdomino-pelvic irradiation should be similarly considered for routine colonoscopy for colorectal cancer."

The authors note that it should be emphasized that the AER for most subsequent primary neoplasms was still relatively low; although for genitourinary and digestive subsequent primary neoplasms, it increased rapidly with attained age, and if continued into old age, a substantial number of survivors would develop such subsequent primary neoplasms. "Given the excesses observed among those older than 40 years, these survivors should be encouraged to participate in existing general population screening programs."


'/>"/>

Contact: Raoul C. Reulen, Ph.D.
r.c.reulen@bham.ac.uk
JAMA and Archives Journals
Source:Eurekalert

Related medicine news :

1. Childhood Cancer Therapies Tied to Gastrointestinal Issues
2. Capacity for Commitment May Start in Early Childhood
3. Experts Say Cholesterol Screenings Should Start in Childhood
4. Childhood cancer survivors at higher risk for future GI complications
5. Sun protects against childhood asthma
6. Cockroach allergens in homes associated with prevalence of childhood asthma in some neighborhoods
7. Cole Foundation injects $700,000 into childhood cancer research
8. Bleak memories of childhood
9. Childhood cancer survivors are at increased risk for ongoing post-therapy GI complications
10. Biological links found between childhood abuse and adolescent depression
11. Childhood music lessons may provide lifelong boost in brain functioning
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:10/13/2017)... SAN LUIS OBISPO, Calif. (PRWEB) , ... October 13, 2017 , ... ... with Alzheimer’s or dementia. However, many long-term care insurance companies have a waiver for ... mean is the 90-day elimination period, when the family pays for care, is often ...
(Date:10/13/2017)... ... October 13, 2017 , ... Talented host, actor Rob ... sciatica in a new episode of "Success Files," which is an award-winning educational ... and investigates each subject in-depth with passion and integrity. , Sciatica occurs when ...
(Date:10/12/2017)... ... 12, 2017 , ... CitiDent and San Francisco dentists, Dr. ... Oventus O2Vent technology. As many as 18 million Americans are estimated to suffer ... Oral appliances can offer significant relief to about 75 percent of people with ...
(Date:10/12/2017)... ... 2017 , ... Asante, a nationally recognized health system in ... existing home health joint venture through an agreement, effective October 1, 2017, to ... home health company with Asante, delivering clinically integrated care, for the past eight ...
(Date:10/12/2017)... ... October 12, 2017 , ... On Saturday, October 21, the Health ... Miles by Moonlight to raise money for the American Heart Association Heart Walk. Teams ... Teams will work together to keep their treadmills moving for 5 hours. Treadmills will ...
Breaking Medicine News(10 mins):
(Date:10/11/2017)...  Hill-Rom Holdings, Inc. ("Hill-Rom") (NYSE: HRC), today provided ... Piedras, Puerto Rico , where the ... Following a comprehensive onsite ... structural damage, temporary loss of power and minimal water ... manufacturing operations have resumed, and the company expects to ...
(Date:10/5/2017)... 2017  In response to the nationwide opioid ... Surgeons (AAOMS) released prescribing recommendations that urge ibuprofen ... as a first-line therapy to manage a patient,s ... Recognizing the value and importance of ... Prescribing: Acute and Postoperative Pain Management" stresses that ...
(Date:10/2/2017)... , Oct. 2, 2017 Diplomat Pharmacy, Inc. ... Day Software and Consulting, LLC , and named its ... Software, based in Tennessee , will ... Day expands EnvoyHealth,s service offerings for health care partners ... "In an interoperable world, ...
Breaking Medicine Technology: