Survivors of childhood cancer are at increased risk for treatment-related subsequent neoplasms (SNs), even after age 40 years, according to a study published in the Journal of Clinical Oncology.
Lucie M. Turcotte, M.D., M.P.H., from the University of Minnesota Medical School in Minneapolis, and colleagues examined SN incidence beyond the age of 40 years in childhood cancer survivors. Among 14,364 survivors, 3,171 had attained an age of 40 years or older at the time of last contact.
The researchers identified 679 SNs that were diagnosed in patients aged 40 years or older, including 196 subsequent malignant neoplasms (SMNs), 419 nonmelanoma skin cancers, 21 nonmalignant meningiomas, and 43 other benign neoplasms. The cumulative incidence of new SNs and SMNs occurring after age 40 years was 34.6 and 16.3 percent, respectively, at age 55 years.
The likelihood of receiving a diagnosis of SMN after age 40 years was increased compared with the general population (standardized incidence ratio [SIR], 2.2; 95 percent confidence interval [CI], 1.9 to 2.5).
Among SMNs, risk was increased for breast cancer, renal cancer, soft tissue sarcoma, and thyroid cancer (SIRs [95 percent CIs]: 5.5 [4.5 to 6.7], 3.9 [2.0 to 7.5], 2.6 [1.5 to 4.4], and 1.9 [1.0 to 3.5], respectively).
In multivariable analysis, female sex and therapeutic radiation exposure correlated with increased risk of SMN (relative risks, 1.9 and 2.2, respectively; both P < 0.001).
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“These data suggest the need for life-long monitoring and should inform anticipatory guidance provided to survivors of childhood cancer,” the authors write.
Two authors disclosed financial ties to the pharmaceutical industry.