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

Reulen, Raoul C; Wong, Kwok F; Bright, Chloe J; Winter, David L; Alessi, Daniela; Allodji, Rodrigue M; Bagnasco, Francesca; Bárdi, Edit; Bautz, Andrea; Byrne, Julianne; Feijen, Elizabeth Am; Fidler-Benaoudia, Miranda M; Diallo, Ibrahim; Garwicz, Stanislaw; Grabow, Desiree; Gudmundsdottir, Thorgerdur; Guha, Joyeeta; Haddy, Nadia; Høgsholt, Stine; Jankovic, Moncilo; ... (2020). Risk of digestive cancers in a cohort of 69 460 five-year survivors of childhood cancer in Europe: the PanCareSurFup study. (In Press). Gut BMJ Publishing Group 10.1136/gutjnl-2020-322237

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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.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Gynaecology, Paediatrics and Endocrinology (DFKE) > Clinic of Paediatric Medicine
04 Faculty of Medicine > Pre-clinic Human Medicine > Institute of Social and Preventive Medicine (ISPM)

UniBE Contributor:

Kuonen, Rahel; Hau Grosch, Eva-Maria and Kühni, Claudia

Subjects:

600 Technology > 610 Medicine & health
300 Social sciences, sociology & anthropology > 360 Social problems & social services

ISSN:

0017-5749

Publisher:

BMJ Publishing Group

Funders:

[4] Swiss National Science Foundation

Language:

English

Submitter:

Doris Kopp Heim

Date Deposited:

10 Nov 2020 22:31

Last Modified:

11 Nov 2020 21:05

Publisher DOI:

10.1136/gutjnl-2020-322237

PubMed ID:

33139271

Uncontrolled Keywords:

CANCER EPIDEMIOLOGY COLORECTAL CANCER COLORECTAL CANCER SCREENING GASTROINTESTINAL CANCER

BORIS DOI:

10.7892/boris.148021

URI:

https://boris.unibe.ch/id/eprint/148021

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