Institute of Public Health Faculty Seminar
Time: 12:10 PM, 27th April
Location：Rm221, Medical Building II
Speaker：prof Jason Liu
Second Primary Cancers of the Digestive System among Childhood and Adolescent Cancer Survivors
Background: The number of childhood and adolescent cancer survivors has been growing due to improved treatments, but second primary cancers have emerged as adverse health events. We used the National Cancer Institute’s Surveillance, Epidemiology and End Results (SEER) Program cancer registries to evaluate risks of developing digestive system cancers in childhood and adolescent cancer survivors.
Methods: A cohort of 41,249 patients diagnosed with first primary cancer from 1975 to 2015 before the age of 20 years who subsequently survived for at least 1 year, was identified from nine SEER registries. Standardized incidence ratios (SIRs) and absolute excess risks (AERs) for digestive system cancers were calculated using age-, sex-, race-, and calendar year-specific SEER incidence rates.
Results: Among the 41,249 cancer survivors, 133 developed second primary digestive system cancer. Cancer survivors had significantly higher risk of developing digestive system cancer compared to the general population (SIR=3.21, 95% CI: 2.68-3.80; AER=1.56 per 10,000 person-years), with median diagnosis age of 37 years. The SIR and AER for developing any digestive system cancer were highest among survivors of bone cancer, lymphoma, and neuroblastoma. Among survivors from any first primary cancer, the SIR was significantly elevated for cancers of the esophagus, stomach, small intestine, large intestine, liver, and pancreas, while the AER was highest for cancers of the large intestine.
Conclusions: Survivors of childhood and adolescent cancers diagnosed from 1975 to 2015 have significantly elevated risks of developing digestive system cancers compared to the general population. Our findings may contribute to the surveillance recommendations of young cancer survivors, and their young median age of digestive system cancer diagnosis suggests a role for early surveillance.