Risk of digestive cancers in a cohort of 69 460 five-year survivors of childhood cancer in Europe: the PanCareSurFup study.

Autor:	Reulen RC; Centre for Childhood Cancer Survivor Studies, University of Birmingham College of Medical and Dental Sciences, Birmingham, Birmingham, UK., Wong KF; National Cancer Registration and Analysis Service, Public Health England, London, UK., Bright CJ; National Cancer Registration and Analysis Service, Public Health England, London, UK., Winter DL; Centre for Childhood Cancer Survivor Studies, University of Birmingham College of Medical and Dental Sciences, Birmingham, Birmingham, UK., Alessi D; Childhood Cancer Registry of Piedmont, Cancer Epidemiology Unit, Department of Medical Sciences, University of Turin and AOU Città della Salute e della Scienza di Torino, Italy, Childhood cancer registry of piedmont, Turin, Italy., Allodji RM; Cancer and Radiation Team, Center for Research in Epidemiology and Population Health, INSERM U1018, University Paris Saclay, Gustave Roussy, Villejuif, France., Bagnasco F; Epidemiology and Biostatistics Unit, Instituto Giannina Gaslini, Genova, Italy., Bárdi E; 2nd Department of Pediatrics, Semmelweis University, Budapest, Hungary.; Kepler Universitätsklinikum, Linz, Austria., Bautz A; Childhood Cancer Research Group, Danish Cancer Society Research Center, Copenhagen, Denmark., Byrne J; Boyne Research Institute, Drogheda, Ireland., Feijen EA; Princess Maxima Center for Pediatric Oncology, Utrecht, The Netherlands., Fidler-Benaoudia MM; Epidemiology and Prevention Research, Departments of Oncology and Community Health Sciences, Calgary, Alberta, Canada., Diallo I; Radiation Epidemiology Team, Center for Research in Epidemiology and Population Health, INSERM U1018, University Paris Saclay, Gustave Roussy, Villejuif, France, Villejuif, France., Garwicz S; Department of Clinical Sciences, Skåne University Hospital, Lund University, Pediatrics, Lund, Skåne, Sweden., Grabow D; German Childhood Cancer Registry, University Medical Centre Mainz, Mainz, Germany., Gudmundsdottir T; Childhood Cancer Research Group, Danish Cancer Society Research Center, Copenhagen, Denmark.; Children's Hospital, Landspitali University Hospital, Reykjavik, Iceland., Guha J; Public Health England and NHS England & Improvement, Birmingham, UK., Haddy N; Radiation Epidemiology Team, Center for Research in Epidemiology and Population Health, INSERM U1018, University Paris Saclay, Gustave Roussy, Villejuif, France, Villejuif, France., Høgsholt S; Childhood Cancer Research Group, Danish Cancer Society Research Center, Copenhagen, Denmark.; Department of Pediatrics, Aarhus University Hospital, Aarhus, Denmark., Jankovic M; Pediatric Clinic, University of Milan-Bicocca, Hospital San Gerardo, Monza, Lombardia, Italy., Kaatsch P; German Childhood Cancer Registry, Institute for Medical Biostatistics, Epidemiology and Informatics, University Medical Center, Johannes Gutenberg University Mainz, Mainz, Germany., Kaiser M; German Childhood Cancer Registry, Institute for Medical Biostatistics, Epidemiology and Informatics, University Medical Center, Johannes Gutenberg University Mainz, Mainz, Germany., Kuonen R; Swiss Childhood Cancer Registry, Institute of Social and Preventive Medicine, University of Bern, Bern, BE, Switzerland., Linge H; Department of Clinical Sciences, Skåne University Hospital, Lund University, Pediatrics, Lund, Skåne, Sweden., Øfstaas H; Norwegian National Advisory Unit on solid tumors in children, Oslo, Norway., Ronckers CM; Princess Maxima Center for Pediatric Oncology, Utrecht, The Netherlands.; Department of pediatric Oncology, Emma Children's Hospital & Academic Medical Center, Amsterdam, The Netherlands., Hau EM; Swiss Childhood Cancer Registry, Institute of Social and Preventive Medicine, University of Bern, Bern, BE, Switzerland.; Department of Paediatrics, University Children's Hospital of Bern, University of Bern, Bern, BE, Switzerland., Skinner R; Great North Children's Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, and Newcastle University Centre for Cancer, Newcastle Upon Tyne, UK., van Leeuwen FE; Department of Epidemiology, Division of Psychosocial Research & Epidemiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands., Teepen JC; Princess Maxima Center for Pediatric Oncology, Utrecht, The Netherlands., Veres C; Radiation Epidemiology Team, Center for Research in Epidemiology and Population Health, INSERM U1018, University Paris Saclay, Gustave Roussy, Villejuif, France, Villejuif, France., Zrafi W; Radiation Epidemiology Team, Center for Research in Epidemiology and Population Health, INSERM U1018, University Paris Saclay, Gustave Roussy, Villejuif, France, Villejuif, France., Debiche G; Radiation Epidemiology Team, Center for Research in Epidemiology and Population Health, INSERM U1018, University Paris Saclay, Gustave Roussy, Villejuif, France, Villejuif, France., Llanas D; Radiation Epidemiology Team, Center for Research in Epidemiology and Population Health, INSERM U1018, University Paris Saclay, Gustave Roussy, Villejuif, France, Villejuif, France., Terenziani M; Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Lombardia, Italy., Vu-Bezin G; Radiation Epidemiology Team, Center for Research in Epidemiology and Population Health, INSERM U1018, University Paris Saclay, Gustave Roussy, Villejuif, France, Villejuif, France., Wesenberg F; Norwegian Cancer Registry and Dept. of Pediatric Medicine, Oslo University Hospital and Institute of Clinical Medicine, Faculty of medicine, University of Oslo, Oslo, Norway., Wiebe T; Department of Clinical Sciences, Skåne University Hospital, Lund University, Pediatrics, Lund, Skåne, Sweden., Sacerdote C; Childhood Cancer Registry of Piedmont, Cancer Epidemiology Unit, Department of Medical Sciences, University of Turin and AOU Città della Salute e della Scienza di Torino, Italy, Childhood cancer registry of piedmont, Turin, Italy., Jakab Z; Hungarian Childhood Cancer Registry, Semmelweis University, 2nd Department of Pediatrics, Budapest, Hungary., Haupt R; Epidemiology and Biostatistics Unit, IRCCS Istituto Giannina Gaslini, Genova, Italy., Lähteenmäki PM; Department of Pediatrics and Adolescent Medicine, Turku University and Turku University Hospital, Turku, Finland., Zadravec Zaletel L; Division of Radiotherapy, Institute of Oncology, Ljubljana, Slovenia., Kuehni CE; Swiss Childhood Cancer Registry, Institute of Social and Preventive Medicine, University of Bern, Bern, BE, Switzerland.; Department of Paediatrics, University Children's Hospital of Bern, University of Bern, Bern, BE, Switzerland., Winther JF; Childhood Cancer Research Group, Danish Cancer Society Research Center, Copenhagen, Denmark.; Department of Clinical Medicine, Faculty of Health, Aarhus University and University Hospital, Aarhus, Denmark., de Vathaire F; Radiation Epidemiology Team, Center for Research in Epidemiology and Population Health, INSERM U1018, University Paris Saclay, Gustave Roussy, Villejuif, France, Villejuif, France., Kremer LC; Princess Maxima Center for Pediatric Oncology, Utrecht, The Netherlands.; Department of pediatric Oncology, Emma Children's Hospital & Academic Medical Center, Amsterdam, The Netherlands., Hjorth L; Department of Clinical Sciences, Skåne University Hospital, Lund University, Pediatrics, Lund, Skåne, Sweden., Hawkins MM; Centre for Childhood Cancer Survivor Studies, University of Birmingham College of Medical and Dental Sciences, Birmingham, Birmingham, UK m.m.hawkins@bham.ac.uk.
Jazyk:	angličtina
Zdroj:	Gut [Gut] 2020 Nov 02. Date of Electronic Publication: 2020 Nov 02.
DOI:	10.1136/gutjnl-2020-322237
Abstrakt:	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. Competing Interests: Competing interests: HL and TW are shareholders in, and have signed an intellectual property agreement with the company Concidera Health. The company develops clinical decision support tools for childhood cancer survivorship. (© Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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