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1. Effect of Web-Based Versus Paper-Based Questionnaires and Follow-Up Strategies on Participation Rates of Dutch Childhood Cancer Survivors: A Randomized Controlled Trial

Author

Kilsdonk, Ellen, van Dulmen-den Broeder, Eline, van der Pal, Helena J, Hollema, Nynke, Kremer, Leontien C, van den Heuvel-Eibrink, Marry M, van Leeuwen, Flora E, Jaspers, Monique W, and van den Berg, Marleen H

Subjects
Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282
Abstract

BackgroundQuestionnaires are widely used in survey research, especially in cohort studies. However, participation in questionnaire studies has been declining over the past decades. Because high participation rates are needed to limit the risk of selection bias and produce valid results, it is important to investigate invitation strategies which may improve participation. ObjectivesThe purpose of this study is to investigate the effect of Web-based versus paper-based questionnaires on participation rates in a questionnaire survey on late effects among childhood cancer survivors (CCSs). MethodsA total of 750 CCSs were randomized across 3 study arms. The initial invitation in study arms 1 and 2 consisted of a Web-based questionnaire only, whereas in study arm 3 this invitation was complemented with a paper-based version of the questionnaire. The first postal reminder, sent to the nonresponding CCSs in all 3 study arms, consisted of either a reminder letter only (study arms 1 and 3) or a reminder letter complemented with a paper-based questionnaire (study arm 2). The second postal reminder was restricted to CCSs in study arms 1 and 2, with only those in study arm 1 also receiving a paper-based questionnaire. CCSs in study arm 3 received a second reminder by telephone instead of by mail. In contrast to CCSs in study arm 3, CCSs in study arms 1 and 2 received a third reminder, this time by telephone. ConclusionInvitation strategies offering a Web-based questionnaire without a paper-based alternative at first invitation can be used without compromising participation rates of CCS. Offering the choice between paper- and Web-based questionnaires seems to result in the highest accrual participation rate. Future research should look into the quality of the data delivered by both questionnaires filled in by respondents themselves. Trial RegistrationInternational Standard Randomized Controlled Trial Number (ISRCTN): 84711754; http://www.controlled-trials.com/ISRCTN84711754 (Archived by WebCite at http://www.webcitation.org/6c9ZB8paX)

Published
2015
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3. Clinical characteristics of subsequent histologically confirmed meningiomas in long-term childhood cancer survivors: A Dutch LATER study

Author

Louwerens, Marloes, de Vries, Andrica, Jaspers, Monique, Hollema, Nynke, den Hartogh, Jaap, Schouten-van Meeteren, Netteke, Verbruggen, Lisanne C., Kok, Judith L., Teepen, Jop C., Janssens, Geert O., de Boer, Charlotte M., Stalpers, Lukas J.A., Vernooij, Meike W., van Dulmen-den Broeder, Eline, Loonen, Jacqueline J., van den Heuvel-Eibrink, Marry M., Tissing, Wim J.E., van der Heiden-van der Loo, Margriet, Versluys, Anne Birgitta, Neggers, Sebastian J.C.M.M., van Leeuwen, Flora E., Hoving, Eelco W., Wesseling, Pieter, Kremer, Leontine C.M., Ronckers, Cécile M., and van der Pal, Helena J.H.

Published
2021
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4. Cohort profile of BIGPROMISE: a perioperative biobank of a high-risk surgical population

Author

Infection & Immunity, Onderzoek, Sepsis and Inflammation, Medische Staf Intensive Care, Noordzij, Peter G., Ruven, Henk Jt, Reniers, Ted, Idema, Rene N., Thio, Maaike Sy, Cremer, Olaf L., Hollema, Nynke, Smit, Kyra N., Vernooij, Lisette M., Dijkstra, Ineke M., Rettig, Thijs Cd, Infection & Immunity, Onderzoek, Sepsis and Inflammation, Medische Staf Intensive Care, Noordzij, Peter G., Ruven, Henk Jt, Reniers, Ted, Idema, Rene N., Thio, Maaike Sy, Cremer, Olaf L., Hollema, Nynke, Smit, Kyra N., Vernooij, Lisette M., Dijkstra, Ineke M., and Rettig, Thijs Cd

Published
2024

5. The cumulative burden of self-reported, clinically relevant outcomes in long-term childhood cancer survivors and implications for survivorship care: A DCCSS LATER study

Author

Klinische Fysica RT, Speerpunt, Zorg en O&O, Cancer, Child Health, SCT patientenzorg, Haematologie patientenzorg, Endocrinologie patientenzorg, Brain, PMC Medisch specialisten, Streefkerk, Nina, Teepen, Jop C., Feijen, Elizabeth A.M., Jóźwiak, Katarzyna, van der Pal, Helena J.H., Ronckers, Cecile M., De Vries, Andrica C.H., Van der Heiden-van Der Loo, Margriet, Hollema, Nynke, van den Berg, Marleen, Loonen, Jacqueline, Grootenhuis, Martha A., Bresters, Dorine, Versluys, A. Brigitta, van Dulmen-den Broeder, Eline, van den Heuvel-Eibrink, Marry M., van Leeuwen, Flora E., Neggers, Sebastian J.C.M.M., Van Santen, Hanneke M., Hawkins, Mike, Hauptmann, Michael, Yoneoka, Daisuke, Korevaar, Joke C., Tissing, Wim J.E., Kremer, Leontien C.M., Klinische Fysica RT, Speerpunt, Zorg en O&O, Cancer, Child Health, SCT patientenzorg, Haematologie patientenzorg, Endocrinologie patientenzorg, Brain, PMC Medisch specialisten, Streefkerk, Nina, Teepen, Jop C., Feijen, Elizabeth A.M., Jóźwiak, Katarzyna, van der Pal, Helena J.H., Ronckers, Cecile M., De Vries, Andrica C.H., Van der Heiden-van Der Loo, Margriet, Hollema, Nynke, van den Berg, Marleen, Loonen, Jacqueline, Grootenhuis, Martha A., Bresters, Dorine, Versluys, A. Brigitta, van Dulmen-den Broeder, Eline, van den Heuvel-Eibrink, Marry M., van Leeuwen, Flora E., Neggers, Sebastian J.C.M.M., Van Santen, Hanneke M., Hawkins, Mike, Hauptmann, Michael, Yoneoka, Daisuke, Korevaar, Joke C., Tissing, Wim J.E., and Kremer, Leontien C.M.

Published
2024

6. The cumulative burden of self‐reported, clinically relevant outcomes in long‐term childhood cancer survivors and implications for survivorship care: A DCCSS LATER study.

Author

Streefkerk, Nina, Teepen, Jop C., Feijen, Elizabeth A. M., Jóźwiak, Katarzyna, van der Pal, Helena J. H., Ronckers, Cecile M., De Vries, Andrica C. H., Van der Heiden‐van Der Loo, Margriet, Hollema, Nynke, van den Berg, Marleen, Loonen, Jacqueline, Grootenhuis, Martha A., Bresters, Dorine, Versluys, A. Brigitta, van Dulmen‐den Broeder, Eline, van den Heuvel‐Eibrink, Marry M., van Leeuwen, Flora E., Neggers, Sebastian J. C. M. M., Van Santen, Hanneke M., and Hawkins, Mike

Subjects
CHILDHOOD cancer, CANCER survivors, MISSING data (Statistics), TUMOR treatment, CONFIDENCE intervals
Abstract

Background: The aim of this study is to evaluate how cumulative burden of clinically relevant, self‐reported outcomes in childhood cancer survivors (CCSs) compares to a sibling control group and to explore how the burden corresponds to levels of care proposed by existing risk stratifications. Methods: The authors invited 5925 5‐year survivors from the Dutch Childhood Cancer Survivor Study (DCCSS LATER) cohort and their 1066 siblings to complete a questionnaire on health outcomes. Health outcomes were validated by self‐reported medication use or medical record review. Missing data on clinically relevant outcomes in CCSs for whom no questionnaire data were available were imputed with predictive mean matching. We calculated the mean cumulative count (MCC) for clinically relevant outcomes. Furthermore, we calculated 30‐year MCC for groups of CCSs based on primary cancer diagnosis and treatment, ranked 30‐year MCC, and compared the ranking to levels of care according to existing risk stratifications. Results: At median 18.5 years after 5‐year survival, 46% of CCSs had at least one clinically relevant outcome. CCSs experienced 2.8 times more health conditions than siblings (30‐year MCC = 0.79; 95% confidence interval [CI], 0.74–0.85 vs. 30‐year MCC = 0.29; 95% CI, 0.25–0.34). CCSs' burden of clinically relevant outcomes consisted mainly of endocrine and vascular conditions and varied by primary cancer type. The ranking of the 30‐year MCC often did not correspond with levels of care in existing risk stratifications. Conclusions: CCSs experience a high cumulative burden of clinically relevant outcomes that was not completely reflected by current risk stratifications. Choices for survivorship care should extend beyond primary tumor and treatment parameters, and should consider also including CCSs' current morbidity. Survivors of childhood cancer experience a high cumulative burden of clinically relevant outcomes. Choices for survivorship care should extend beyond primary tumor and treatment parameters and should also consider including the current morbidity of childhood cancer survivors. [ABSTRACT FROM AUTHOR]

Published
2024
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7. Psychosocial functioning of adult siblings of Dutch very long-term survivors of childhood cancer:DCCSS-LATER 2 psycho-oncology study

Author

Joosten, Mala M.H., van Gorp, Marloes, van Dijk, Jennifer, Kremer, Leontien C.M., van Dulmen-den Broeder, Eline, Tissing, Wim J.E., Loonen, Jacqueline J., van der Pal, Helena J.H., de Vries, Andrica C.H., van den Heuvel-Eibrink, Marry M., Ronckers, Cécile, Bresters, Dorine, Louwerens, Marloes, Neggers, Sebastian J.C.C.M., van der Heiden-van der Loo, Margriet, Maurice-Stam, Heleen, Grootenhuis, Martha A., Versluys, Birgitta, van Leeuwen, Flora, van der Steeg, Lideke, Janssens, Geert, van Santen, Hanneke, Veening, Margreet, den Hartogh, Jaap, Pluijm, Saskia, Batenburg, Lilian, de Ridder, Hanneke, Hollema, Nynke, Teunissen, Lennart, Schellekens, Anke, Joosten, Mala M.H., van Gorp, Marloes, van Dijk, Jennifer, Kremer, Leontien C.M., van Dulmen-den Broeder, Eline, Tissing, Wim J.E., Loonen, Jacqueline J., van der Pal, Helena J.H., de Vries, Andrica C.H., van den Heuvel-Eibrink, Marry M., Ronckers, Cécile, Bresters, Dorine, Louwerens, Marloes, Neggers, Sebastian J.C.C.M., van der Heiden-van der Loo, Margriet, Maurice-Stam, Heleen, Grootenhuis, Martha A., Versluys, Birgitta, van Leeuwen, Flora, van der Steeg, Lideke, Janssens, Geert, van Santen, Hanneke, Veening, Margreet, den Hartogh, Jaap, Pluijm, Saskia, Batenburg, Lilian, de Ridder, Hanneke, Hollema, Nynke, Teunissen, Lennart, and Schellekens, Anke

Published
2023

8. Self-reported outcomes on oral health and oral health-related quality of life in long-term childhood cancer survivors—A DCCSS-LATER 2 Study

Author

Stolze, Juliette, Raber-Durlacher, Judith E., Loonen, Jacqueline J., Teepen, Jop C., Ronckers, Cécile M., Tissing, Wim J.E., de Vries, Andrica C.H., Neggers, Sebastian J.C.M.M., Dulmen-den Broeder, Eline, Heuvel-Eibrink, Marry M., van der Pal, Helena J.H., Versluys, A. Birgitta, Heiden-van der Loo, Margriet, Louwerens, Marloes, Kremer, Leontien C.M., Bresters, Dorine, Brand, Henk S., Grootenhuis, Martha, van Leeuwen, Flora, van der Steeg, Lideke, Janssens, Geert, van Santen, Hanneke, Veening, Margreet, den Hartoghg, Jaap, Pluijm, Saskia, Batenburg, Lilian, de Ridder, Hanneke, Hollema, Nynke, Teunissen, Lennart, Schellekens, Anke, Stolze, Juliette, Raber-Durlacher, Judith E., Loonen, Jacqueline J., Teepen, Jop C., Ronckers, Cécile M., Tissing, Wim J.E., de Vries, Andrica C.H., Neggers, Sebastian J.C.M.M., Dulmen-den Broeder, Eline, Heuvel-Eibrink, Marry M., van der Pal, Helena J.H., Versluys, A. Birgitta, Heiden-van der Loo, Margriet, Louwerens, Marloes, Kremer, Leontien C.M., Bresters, Dorine, Brand, Henk S., Grootenhuis, Martha, van Leeuwen, Flora, van der Steeg, Lideke, Janssens, Geert, van Santen, Hanneke, Veening, Margreet, den Hartoghg, Jaap, Pluijm, Saskia, Batenburg, Lilian, de Ridder, Hanneke, Hollema, Nynke, Teunissen, Lennart, and Schellekens, Anke

Abstract

Purpose: The present study aimed to determine the prevalence of self-reported oral problems and the oral health–related quality of life (OHRQoL) in childhood cancer survivors (CCS). Methods: Patient and treatment characteristics of CCS have been collected in a cross-sectional study, part of the multidisciplinary DCCSS-LATER 2 Study. To assess self-reported oral health problems and dental problems, CCS filled out the ‘Toegepast-Natuurwetenschappelijk Onderzoek’ (TNO) oral health questionnaire. OHRQoL was assessed by the Dutch version of the Oral Health Impact Profile-14 (OHIP-14). Prevalences were compared with two comparison groups from the literature. Univariable and multivariable analyses were performed. Results: A total of 249 CCS participated in our study. The OHIP-14 total score had a mean value of 1.94 (sd 4.39), with a median score of 0 (range 0–29). The oral problems ‘oral blisters/aphthae’ (25.9%) and ‘bad odor/halitosis’ (23.3%) were significantly more often reported in CCS than in comparison groups (12% and 12%, respectively). The OHIP-14 score was significantly correlated with the number of self-reported oral health problems (r =.333, p<0.0005) and dental problems (r =.392, p <0.0005). In multivariable analysis, CCS with a shorter time since diagnosis (10-19 years vs. ≥30 years) had a 1.47-fold higher risk of ≥1 oral health problem. Conclusion: Though the perceived oral health is relatively good, oral complications following childhood cancer treatment are prevalent in CCS. This underlines that attention to impaired oral health and awareness on this topic is mandatory and regular visits to the dentist should be a part of long-term follow-up care.

Published
2023

9. Questionnaire- and linkage-based outcomes in Dutch childhood cancer survivors:Methodology of the DCCSS LATER study part 1

Author

Teepen, Jop C., Kok, Judith L., Feijen, Elizabeth A.M., Loonen, Jacqueline J., van den Heuvel-Eibrink, Marry M., van der Pal, Helena J., Tissing, Wim J.E., Bresters, Dorine, Versluys, Birgitta, Grootenhuis, Martha A., Louwerens, Marloes, Neggers, Sebastian J.C.M.M., van Santen, Hanneke M., de Vries, Andrica, Janssens, Geert O., den Hartogh, Jaap G., van Leeuwen, Flora E., Hollema, Nynke, Streefkerk, Nina, Kilsdonk, Ellen, van der Heiden-van der Loo, Margriet, van Dulmen-den Broeder, Eline, Ronckers, Cécile M., Kremer, Leontien C.M., Teepen, Jop C., Kok, Judith L., Feijen, Elizabeth A.M., Loonen, Jacqueline J., van den Heuvel-Eibrink, Marry M., van der Pal, Helena J., Tissing, Wim J.E., Bresters, Dorine, Versluys, Birgitta, Grootenhuis, Martha A., Louwerens, Marloes, Neggers, Sebastian J.C.M.M., van Santen, Hanneke M., de Vries, Andrica, Janssens, Geert O., den Hartogh, Jaap G., van Leeuwen, Flora E., Hollema, Nynke, Streefkerk, Nina, Kilsdonk, Ellen, van der Heiden-van der Loo, Margriet, van Dulmen-den Broeder, Eline, Ronckers, Cécile M., and Kremer, Leontien C.M.

Abstract

Background: Childhood cancer survivors are at risk for developing long-term adverse health outcomes. To identify the risk of and risk factors for specific health outcomes, well-established cohorts are needed with detailed information on childhood cancer diagnosis, treatment, and health outcomes. We describe the design, methodology, characteristics, and data availability of the Dutch Childhood Cancer Survivor Study LATER cohort (1963–2001) part 1; questionnaire and linkage studies. Methods: The LATER cohort includes 5-year childhood cancer survivors, diagnosed in the period 1963–2001, and before the age of 18 in any of the seven former pediatric oncology centers in the Netherlands. Information on health outcomes from survivors and invited siblings of survivors was collected by questionnaires and linkages to medical registries. Results: In total, 6165 survivors were included in the LATER cohort. Extensive data on diagnosis and treatment have been collected. Information on a variety of health outcomes has been ascertained by the LATER questionnaire study and linkages with several registries for subsequent tumors, health care use, and hospitalizations. Conclusion: Research with data of the LATER cohort will provide new insights into risks of and risk factors for long-term health outcomes. This can enhance risk stratification for childhood cancer survivors and inform surveillance guidelines and development of interventions to prevent (the impact of) long-term adverse health outcomes. The data collected will be a solid baseline foundation for future follow-up studies.

Published
2023

10. Questionnaire‐ and linkage‐based outcomes in Dutch childhood cancer survivors: Methodology of the DCCSS LATER study part 1.

Author

Teepen, Jop C., Kok, Judith L., Feijen, Elizabeth A. M., Loonen, Jacqueline J., van den Heuvel‐Eibrink, Marry M., van der Pal, Helena J., Tissing, Wim J. E., Bresters, Dorine, Versluys, Birgitta, Grootenhuis, Martha A., Louwerens, Marloes, Neggers, Sebastian J. C. M. M., van Santen, Hanneke M., de Vries, Andrica, Janssens, Geert O., den Hartogh, Jaap G., van Leeuwen, Flora E., Hollema, Nynke, Streefkerk, Nina, and Kilsdonk, Ellen

Subjects
CHILDHOOD cancer, CANCER survivors, MEDICAL registries, MEDICAL care use, PEDIATRIC oncology, CANCER fatigue
Abstract

Background: Childhood cancer survivors are at risk for developing long‐term adverse health outcomes. To identify the risk of and risk factors for specific health outcomes, well‐established cohorts are needed with detailed information on childhood cancer diagnosis, treatment, and health outcomes. We describe the design, methodology, characteristics, and data availability of the Dutch Childhood Cancer Survivor Study LATER cohort (1963–2001) part 1; questionnaire and linkage studies. Methods: The LATER cohort includes 5‐year childhood cancer survivors, diagnosed in the period 1963–2001, and before the age of 18 in any of the seven former pediatric oncology centers in the Netherlands. Information on health outcomes from survivors and invited siblings of survivors was collected by questionnaires and linkages to medical registries. Results: In total, 6165 survivors were included in the LATER cohort. Extensive data on diagnosis and treatment have been collected. Information on a variety of health outcomes has been ascertained by the LATER questionnaire study and linkages with several registries for subsequent tumors, health care use, and hospitalizations. Conclusion: Research with data of the LATER cohort will provide new insights into risks of and risk factors for long‐term health outcomes. This can enhance risk stratification for childhood cancer survivors and inform surveillance guidelines and development of interventions to prevent (the impact of) long‐term adverse health outcomes. The data collected will be a solid baseline foundation for future follow‐up studies. [ABSTRACT FROM AUTHOR]

Published
2023
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11. Clinical characteristics of subsequent histologically confirmed meningiomas in long-term childhood cancer survivors: A Dutch LATER study

Author

Verbruggen, Lisanne C., primary, Kok, Judith L., additional, Teepen, Jop C., additional, Janssens, Geert O., additional, de Boer, Charlotte M., additional, Stalpers, Lukas J.A., additional, Vernooij, Meike W., additional, van Dulmen-den Broeder, Eline, additional, Loonen, Jacqueline J., additional, van den Heuvel-Eibrink, Marry M., additional, Tissing, Wim J.E., additional, van der Heiden-van der Loo, Margriet, additional, Versluys, Anne Birgitta, additional, Neggers, Sebastian J.C.M.M., additional, van Leeuwen, Flora E., additional, Hoving, Eelco W., additional, Wesseling, Pieter, additional, Kremer, Leontine C.M., additional, Ronckers, Cécile M., additional, van der Pal, Helena J.H., additional, Louwerens, Marloes, additional, de Vries, Andrica, additional, Jaspers, Monique, additional, Hollema, Nynke, additional, den Hartogh, Jaap, additional, and Schouten-van Meeteren, Netteke, additional

Published
2021
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12. Long-Term Risk of Skin Cancer among Childhood Cancer Survivors : A DCOG-LATER Cohort Study

Author

Teepen, Jop C., Kok, Judith L., Kremer, Leontien C., Tissing, Wim J.E., Van Den Heuvel-Eibrink, Marry M., Loonen, Jacqueline J., Bresters, Dorine, Van Der Pal, Helena J., Versluys, Birgitta, Van Dulmen-Den Broeder, Eline, Nijsten, Tamar, Hauptmann, Michael, Hollema, Nynke, Dolsma, Wil V., Van Leeuwen, Flora E., Ronckers, Cécile M., Teepen, Jop C., Kok, Judith L., Kremer, Leontien C., Tissing, Wim J.E., Van Den Heuvel-Eibrink, Marry M., Loonen, Jacqueline J., Bresters, Dorine, Van Der Pal, Helena J., Versluys, Birgitta, Van Dulmen-Den Broeder, Eline, Nijsten, Tamar, Hauptmann, Michael, Hollema, Nynke, Dolsma, Wil V., Van Leeuwen, Flora E., and Ronckers, Cécile M.

Published
2019

13. Long-Term Risk of Skin Cancer among Childhood Cancer Survivors: A DCOG-LATER Cohort Study

Author

PMC Medisch specialisten, Speerpunt, Zorg en O&O, Child Health, SCT patientenzorg, Klinische Fysica RT, Teepen, Jop C., Kok, Judith L., Kremer, Leontien C., Tissing, Wim J.E., Van Den Heuvel-Eibrink, Marry M., Loonen, Jacqueline J., Bresters, Dorine, Van Der Pal, Helena J., Versluys, Birgitta, Van Dulmen-Den Broeder, Eline, Nijsten, Tamar, Hauptmann, Michael, Hollema, Nynke, Dolsma, Wil V., Van Leeuwen, Flora E., Ronckers, Cécile M., PMC Medisch specialisten, Speerpunt, Zorg en O&O, Child Health, SCT patientenzorg, Klinische Fysica RT, Teepen, Jop C., Kok, Judith L., Kremer, Leontien C., Tissing, Wim J.E., Van Den Heuvel-Eibrink, Marry M., Loonen, Jacqueline J., Bresters, Dorine, Van Der Pal, Helena J., Versluys, Birgitta, Van Dulmen-Den Broeder, Eline, Nijsten, Tamar, Hauptmann, Michael, Hollema, Nynke, Dolsma, Wil V., Van Leeuwen, Flora E., and Ronckers, Cécile M.

Published
2019

14. Long-Term Risk of Skin Cancer Among Childhood Cancer Survivors: A DCOG-LATER Cohort Study.

Author

Teepen, Jop C, Kok, Judith L, Kremer, Leontien C, Tissing, Wim J E, Heuvel-Eibrink, Marry M van den, Loonen, Jacqueline J, Bresters, Dorine, Pal, Helena J van der, Versluys, Birgitta, Broeder, Eline van Dulmen-den, Nijsten, Tamar, Hauptmann, Michael, Hollema, Nynke, Dolsma, Wil V, Leeuwen, Flora E van, Ronckers, Cécile M, Group, DCOG-LATER Study, van den Heuvel-Eibrink, Marry M, van der Pal, Helena J, and van Dulmen-den Broeder, Eline

Subjects
CHILDHOOD cancer, SKIN cancer, BASAL cell carcinoma, CANCER patients, CANCER risk factors, CANCER radiotherapy complications, ANTINEOPLASTIC agents
Abstract

Background: Skin cancer is common after radiotherapy among childhood cancer survivors (CCSs). We studied risks and risk factors for subsequent skin cancers, with emphasis on radiation dose, exposed skin surface area, and chemotherapeutic agents.Methods: The DCOG-LATER cohort study includes 5-year Dutch CCSs diagnosed 1963-2001. Subsequent skin cancers were identified from record linkages with the Netherlands Cancer Registry and Dutch Pathology Registry. Incidence rates were compared with general population rates. Multivariable Cox regression models were used, applying a novel method of case-control sampling enabling use of tumor location in cohort analyses. All statistical tests were two-sided.Results: Among 5843 CCSs, 259 developed 1061 basal cell carcinomas (BCCs) (standardized incidence ratio [SIR] = 29.8, 95% confidence interval [CI] = 26.3 to 33.6; excess absolute risk per 10 000 person-years (EAR) = 24.6), 20 had melanoma (SIR = 2.3, 95% CI = 1.4 to 3.5; EAR = 1.1), and 10 had squamous cell carcinoma (SIR = 7.5, 95% CI = 3.6 to 13.8; EAR = 0.8). Cumulative incidence of BCC 40 years after childhood cancer was 19.1% (95% CI = 16.6 to 21.8%) after radiotherapy vs 0.6% expected based on general population rates. After a first BCC, 46.7% had more BCCs later. BCC risk was associated with any radiotherapy to the skin compartment of interest (hazard ratio [HR] = 14.32, 95% CI = 10.10 to 20.29) and with estimated percentage in-field skin surface area (26-75%: HR = 1.99, 95% CI = 1.24 to 3.20; 76-100%: HR = 2.16, 95% CI = 1.33 to 3.53, vs 1-25% exposed; Ptrend among exposed = .002), but not with prescribed radiation dose and likelihood of sun-exposed skin-area. Of all chemotherapy groups examined, only vinca alkaloids increased BCC risk (HR = 1.54, 95% CI = 1.04 to 2.27).Conclusion: CCSs have a strongly, 30-fold increased BCC risk. BCC risk appears to increase with increasing skin surface area exposed. This knowledge underscores the need for awareness by survivors and their health care providers. [ABSTRACT FROM AUTHOR]

Published
2019
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