Cumulative Absolute Risk of Subsequent Colorectal Cancer After Abdominopelvic Radiotherapy Among Childhood Cancer Survivors: A PanCareSurFup Study-Reference-Cited by-同舟云学术

Cumulative Absolute Risk of Subsequent Colorectal Cancer After Abdominopelvic Radiotherapy Among Childhood Cancer Survivors: A PanCareSurFup Study

Published:2024-01-20 Issue:3 Volume:42 Page:336-347
ISSN:0732-183X
Container-title:Journal of Clinical Oncology
language:en
Short-container-title:JCO

Author:

Heymer Emma J.¹^ORCID,Jóźwiak Katarzyna²^ORCID,Kremer Leontien C.³⁴,Winter David L.¹^ORCID,de Vathaire Florent⁵^ORCID,Sunguc Ceren¹,Sugden Elaine¹,Kok Judith L.³^ORCID,van der Pal Helena J.H.³^ORCID,Hjorth Lars⁶^ORCID,Jakab Zsuzsanna⁷^ORCID,Maule Milena M.⁸^ORCID,Haupt Riccardo⁹^ORCID,Bagnasco Francesca¹⁰^ORCID,Terenziani Monica¹¹,Diallo Ibrahima⁵^ORCID,Gunnes Maria W.¹²¹³,Sommer Grit¹⁴^ORCID,Zadravec Zaletel Lorna¹⁵^ORCID,Kuehni Claudia E.¹⁴¹⁶^ORCID,Winther Jeanette F.¹⁷¹⁸^ORCID,Lähteenmäki Päivi M.¹⁹^ORCID,Gudmundsdottir Thorgerdur¹⁷²⁰,Allodji Rodrigue S.⁵^ORCID,Skinner Roderick²¹^ORCID,Ronckers Cécile M.³²²^ORCID,Hawkins Michael M.¹^ORCID,Reulen Raoul C.¹^ORCID,Teepen Jop C.³^ORCID

Affiliation:

1. Centre for Childhood Cancer Survivor Studies, Institute of Applied Health Research, University of Birmingham, Birmingham, United Kingdom

2. Institute of Biostatistics and Registry Research, Brandenburg Medical School Theodor Fontane, Neuruppin, Germany

3. Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands

4. Emma Children's Hospital, Amsterdam UMC, Amsterdam, the Netherlands

5. Radiation Epidemiology Team, Center for Research in Epidemiology and Population Health, INSERM U1018, Gustave Roussy, University Paris Saclay, Villejuif, France

6. Department of Clinical Sciences Lund, Paediatrics,Skane University Hospital, Lund University, Lund, Sweden

7. Hungarian Childhood Cancer Registry, 2nd Department of Pediatrics, Semmelweis University, Budapest, Hungary

8. Childhood Cancer Registry of Piedmont, Cancer Epidemiology Unit, Department of Medical Sciences, University of Turin and CPO-Piemonte, AOU Città della Salute e della Scienza di Torino, Turin, Italy

9. Division of Hematology/Oncology, IRCCS Istituto Giannina Gaslini, DOPO Clinic, Genova, Italy

10. Scientific Directorate, IRCCS Istituto Giannina Gaslini, Genova, Italy

11. Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy

12. Division of Paediatric and Adolescent Medicine, Oslo University Hospital Rikshospitalet, Oslo, Norway

13. Department of Registration, Cancer Registry of Norway, Oslo, Norway

14. Childhood Cancer Research Group, Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland

15. Division of Radiotherapy, Institute of Oncology, Ljubljana, Slovenia

16. Division of Pediatric Hematology/Oncology, Department of Paediatrics, University Children's Hospital of Bern, University of Bern, Bern, Switzerland

17. Danish Cancer Society Research Center, Childhood Cancer Research Group, Copenhagen, Denmark

18. Department of Clinical Medicine, Faculty of Health, Aarhus University and University Hospital, Aarhus, Denmark

19. Department of Pediatrics and Adolescent Medicine, Turku University and Turku University Hospital, Turku, Finland

20. Children's Hospital, Landspitali University Hospital, Reykjavik, Iceland

21. Great North Children's Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, and Newcastle University Centre for Cancer, Newcastle University, Newcastle upon Tyne, United Kingdom

22. Department of Health Services Research, Carl von Ossietzky University of Oldenburg, Oldenburg, Germany

Abstract

PURPOSE Childhood cancer survivors are at the risk of developing subsequent colorectal cancers (CRCs), but the absolute risks by treatment modality are uncertain. We quantified the absolute risks by radiotherapy treatment characteristics using clinically accessible data from a Pan-European wide case-control study nested within a large cohort of childhood cancer survivors: the PanCareSurFup Study. METHODS Odds ratios (ORs) from a case-control study comprising 143 CRC cases and 143 controls nested within a cohort of 69,460 survivors were calculated. These, together with standardized incidence ratios for CRC for this cohort and European general population CRC incidence rates and survivors' mortality rates, were used to estimate cumulative absolute risks (CARs) by attained age for different categories of radiation to the abdominopelvic area. RESULTS Overall, survivors treated with abdominopelvic radiotherapy treatment (ART) were three times more likely to develop a subsequent CRC than those who did not receive ART (OR, 3.1 [95% CI, 1.4 to 6.6]). For male survivors treated with ART, the CAR was 0.27% (95% CI, 0.17 to 0.59) by age 40 years, 1.08% (95% CI, 0.69 to 2.34) by age 50 years (0.27% expected in the general population), and 3.7% (95% CI, 2.36 to 7.80) by age 60 years (0.95% expected). For female survivors treated with ART, the CAR was 0.29% (95% CI, 0.18 to 0.62) by age 40 years, 1.03% (95% CI, 0.65 to 2.22) by age 50 years (0.27% expected), and 3.0% (95% CI, 1.91 to 6.37) by age 60 years (0.82% expected). CONCLUSION We demonstrated that by age 40 years survivors of childhood cancer treated with ART already have a similar risk of CRC as those age 50 years in the general population for whom population-based CRC screening begins in many countries. This information should be used in the development of survivorship guidelines for the risk stratification of survivors concerning CRC risk.

Publisher

American Society of Clinical Oncology (ASCO)

Subject

Cancer Research,Oncology

Link

https://ascopubs.org/doi/pdfdirect/10.1200/JCO.23.00452

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