Back to Search
Start Over
Secondary cancers after a childhood cancer diagnosis: a nationwide hospital-based retrospective cohort study in Japan.
- Source :
-
International journal of clinical oncology [Int J Clin Oncol] 2016 Jun; Vol. 21 (3), pp. 506-16. Date of Electronic Publication: 2015 Nov 30. - Publication Year :
- 2016
-
Abstract
- Background: The epidemiology of secondary cancers in childhood cancer survivors has been unknown in Asian countries. Our aim is to assess the incidence and risk factors for secondary cancers through a nationwide survey in Japan.<br />Methods: A retrospective cohort study comprising 10,069 children who were diagnosed with cancer between 1980 and 2009 was conducted in 15 Japanese hospitals. The cumulative incidence rate was calculated using death as the competing risk and compared by the Gray method. The standardized incidence ratio (SIR) was defined as the ratio of the number of observed cancers divided by the number of expected cancers. The risk factors were analyzed using Cox regression analysis.<br />Results: One hundred and twenty-eight patients (1.3 %) developed secondary cancers within a median follow-up of 8.4 years. The cumulative incidence rate was 1.1 % (95 % confidence interval [CI] 0.9-1.4) at 10 years and 2.6 % (95 % CI 2.1-3.3) at 20 years after primary cancer diagnosis. Sensitivity analysis, limited to 5-year survivors (n = 5,387), confirmed these low incidence rates. The SIR of secondary cancers was 12.1 (95 % CI 10.1-14.4). In the Cox analysis, the hazard ratios for secondary cancers were 3.81 (95 % CI 1.53-9.47) for retinoblastoma, 2.78 (95 % CI 1.44-5.38) for bone/soft tissue sarcomas, and 1.81 (95 % CI 1.16-2.83) for allogeneic stem cell transplantation.<br />Conclusions: The cumulative incidence of secondary cancers in children in Japan was not high; however, the SIR was relatively high. Retinoblastoma or sarcoma in addition to allogeneic stem cell transplantation were significant risk factors for secondary cancers.
- Subjects :
- Adolescent
Adult
Child
Child, Preschool
Female
Follow-Up Studies
Humans
Incidence
Infant
Japan
Male
Proportional Hazards Models
Retrospective Studies
Risk Factors
Stem Cell Transplantation statistics & numerical data
Surveys and Questionnaires
Survival Rate
Time Factors
Transplantation, Homologous statistics & numerical data
Young Adult
Bone Neoplasms therapy
Neoplasms, Second Primary epidemiology
Retinal Neoplasms therapy
Retinoblastoma therapy
Sarcoma therapy
Soft Tissue Neoplasms therapy
Survivors statistics & numerical data
Subjects
Details
- Language :
- English
- ISSN :
- 1437-7772
- Volume :
- 21
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- International journal of clinical oncology
- Publication Type :
- Academic Journal
- Accession number :
- 26620038
- Full Text :
- https://doi.org/10.1007/s10147-015-0927-z