Risk of a second cancer in Canadians diagnosed with a first cancer in childhood or adolescence.
EClinicalMedicine
; 16: 107-120, 2019 Nov.
Article
em En
| MEDLINE
| ID: mdl-31832625
ABSTRACT
BACKGROUND:
Second cancers are an adverse outcome experienced by childhood cancer survivors. We quantify the risk and correlates of a second cancer in Canadians diagnosed with a first cancer prior to age 20 years.METHODS:
Using death-linked Canadian Cancer Registry data, a population-based cohort diagnosed with a first cancer between 1992 and 2014, prior to age 20 years, were followed for occurrence of a second cancer to the end of 2014. We estimate standardized incidence ratios (SIR), absolute excess risks (AER), cumulative probabilities, and hazard ratios (HR).FINDINGS:
22,635 people contributed 204,309â¢1 person-years of follow-up. Overall risk of a second cancer was 6â¢5 (95% CI 5â¢8-7â¢1) times greater than expected resulting in an AER of 16â¢5 (14â¢4-18â¢5) cancers per 10,000 person-years and a 4â¢8% (3â¢8%-6â¢0%) cumulative probability of a second cancer at 22â¢6 years of follow-up. SIRs decreased with increasing age at diagnosis and time since diagnosis; were larger in more recent calendar periods of diagnosis; and varied by type of first cancer. Large SIRs in the first year after diagnosis and in those diagnosed in 2010-2014 were partly associated with changing registry practices. For the whole cohort, factors associated with the hazard of a second cancer included being female vs. male [HR = 1â¢439 (95%CI 1â¢179-1â¢760)]; being diagnosed in 2005-2014 vs. 1992-2004 [2â¢084 (1â¢598-2â¢719)]; having synchronous first cancers [4â¢814 (2â¢042-9â¢509)]; and being diagnosed with certain types of cancer. Factors varied, however, by type of first cancer.INTERPRETATION:
Risks of a second cancer are not equally distributed and can be impacted by changes in registry practice and the methods used to define second cancers.
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Base de dados:
MEDLINE
Tipo de estudo:
Diagnostic_studies
/
Etiology_studies
/
Risk_factors_studies
Idioma:
En
Ano de publicação:
2019
Tipo de documento:
Article