Risk of digestive cancers in a cohort of 69 460 five-year survivors of childhood cancer in Europe: the PanCareSurFup study
2 Public Health England [London]
3 UNITO - Università degli studi di Torino = University of Turin
4 A.O.U - Città della Salute e della Scienza di Torino
5 CESP - Centre de recherche en épidémiologie et santé des populations
6 IGR - Institut Gustave Roussy
7 Istituto Giannina Gaslini, Genova
8 Semmelweis University [Budapest]
9 Kepler University Hospital
10 DCSRC - Danish Cancer Society Research Center
11 Boyne Research Institute, 5 Bolton Square, East, Drogheda, Co., Louth, A92 RY6K, Ireland
12 Princess Máxima Center for Pediatric Oncology [Utrecht, Netherlands]
13 University of Calgary
14 Skane University Hospital [Lund]
15 Lund University
16 University Medical Center [Mainz]
17 Landspitali National University Hospital of Iceland
18 Public Health England - Midlands and east of England regional office [Birmimgham]
19 Aarhus University Hospital
20 UNIMIB - Università degli Studi di Milano-Bicocca = University of Milano-Bicocca
21 SGH - San Gerardo Hospital Company Monza
22 Universitätsmedizin der Johannes Gutenberg-Universität Mainz - University Medical Center of the Johannes Gutenberg-University Mainz [Germany]
23 Institute for Medical Biostatistics, Epidemiology and Informatics (IMBEI)
24 GCCR - German Childhood Cancer Registry [Mainz, Germany]
25 German Childhood Cancer Registry, Institute for Medical Biostatistics, Epidemiology and Informatics (IMBEI)
26 UNIBE - Universität Bern = University of Bern = Université de Berne
27 Norwegian National Advisory Unit on Solid Tumors in Children [Oslo, Norway]
28 Emma Children’s Hospital
29 Inselspital Bern
30 Newcastle Upon Tyne Hospitals NHS Foundation Trust
31 Newcastle University [Newcastle]
32 NKI - Netherlands Cancer Institute
33 IRCCS Istituto Nazionale dei Tumori [Milano]
34 Oslo University Hospital [Oslo]
35 UiO - University of Oslo
36 IRCCS Istituto Giannina Gaslini [Genoa, Italy]
37 University of Turku
38 Institute of Oncology [Ljubljana]
39 Aarhus University [Aarhus]
40 Academic Medical Center - Emma Children's Hospital [Amsterdam, Netherlands]
- Fonction : Auteur
- PersonId : 1297193
- ORCID : 0000-0002-7328-0467
- Fonction : Auteur
- PersonId : 4839
- IdHAL : rodrigue-setcheou-allodji
- ORCID : 0000-0002-1895-8415
- Fonction : Auteur
- Fonction : Auteur
- PersonId : 804838
- ORCID : 0000-0001-8957-2002
- IdRef : 186420374
Résumé
Background Survivors of childhood cancer are at risk of subsequent primary neoplasms (SPNs), but the risk of developing specific digestive SPNs beyond age 40 years remains uncertain. We investigated risks of specific digestive SPNs within the largest available cohort worldwide. Methods The PanCareSurFup cohort includes 69 460 five-year survivors of childhood cancer from 12 countries in Europe. Risks of digestive SPNs were quantified using standardised incidence ratios (SIRs), absolute excess risks and cumulative incidence. Results 427 digestive SPNs (214 colorectal, 62 liver, 48 stomach, 44 pancreas, 59 other) were diagnosed in 413 survivors. Wilms tumour (WT) and Hodgkin lymphoma (HL) survivors were at greatest risk (SIR 12.1; 95% CI 9.6 to 15.1; SIR 7.3; 95% CI 5.9 to 9.0, respectively). The cumulative incidence increased the most steeply with increasing age for WT survivors, reaching 7.4% by age 55% and 9.6% by age 60 years (1.0% expected based on general population rates). Regarding colorectal SPNs, WT and HL survivors were at greatest risk; both seven times that expected. By age 55 years, 2.3% of both WT (95% CI 1.4 to 3.9) and HL (95% CI 1.6 to 3.2) survivors had developed a colorectal SPN—comparable to the risk among members of the general population with at least two first-degree relatives affected. Conclusions Colonoscopy surveillance before age 55 is recommended in many European countries for individuals with a family history of colorectal cancer, but not for WT and HL survivors despite a comparable risk profile. Clinically, serious consideration should be given to the implementation of colonoscopy surveillance while further evaluation of its benefits, harms and cost-effectiveness in WT and HL survivors is undertaken.