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. 2007 Jan;43(2):351-62.
doi: 10.1016/j.ejca.2006.10.004. Epub 2006 Dec 1.

Risk of second malignancies in long-term survivors of childhood cancer

M C Cardous-Ubbink  1 , R C Heinen, P J M Bakker, H van den Berg, F Oldenburger, H N Caron, P A Voûte, F E van Leeuwen
Affiliations

Risk of second malignancies in long-term survivors of childhood cancer

M C Cardous-Ubbink et al. Eur J Cancer. 2007 Jan.

Abstract

Introduction: Childhood cancer survivors are known to be at increased risk for second malignancies.

Patients and methods: The risk of second malignancies was assessed in 1368 5-year survivors of childhood cancer treated in the Emma Children's Hospital AMC in Amsterdam. The median follow-up time was 16.8 years.

Results: Sixty two malignancies were observed against 5.4 expected, yielding a standardised incidence ratio (SIR) of 11.2 (95% confidence interval: 8.53-14.4; absolute excess risk: 3.2 per 1000 person-years). New observations were the strongly increased risks of meningiomas (SIR=40) and basal cell carcinomas (SIR=9). Patients whose treatment involved radiotherapy had a 2-fold increased second cancer risk compared to patients with chemotherapy alone.

Discussion: The relative risk of second malignancies does not decrease till at least 30 years of follow-up. With aging of the survivor cohort this results in a strong increase of the AER, due to the rising background risk of cancer with age.

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