Second primary cancers in people who had cancer as children: an Australian Childhood Cancer Registry population-based study

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Youlden, Danny R
Baade, Peter D
Green, Adèle C
Valery, Patricia C
Moore, Andrew S
Aitken, Joanne F
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2019
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Abstract

OBJECTIVE: To investigate the incidence of second primary cancers in people diagnosed with cancer during childhood. DESIGN, SETTING: Retrospective, population-based study; analysis of Australian Childhood Cancer Registry data. PARTICIPANTS: People alive at least two months after being diagnosed before the age of 15 years with a primary cancer, 1983-2013, followed until 31 December 2015 (2-33 years' follow-up). MAIN OUTCOME MEASURES: Risks of second primary cancer compared with the general population, expressed as standardised incidence ratios (SIRs). RESULTS: Among 18 230 people diagnosed with cancer during childhood, 388 (2%) were later diagnosed with second primary cancers; the estimated 30-year cumulative incidence of second cancers was 4.4% (95% CI, 3.8-5.0%). The risk of a new primary cancer was five times as high as for the general population (SIR, 5.13; 95% CI, 4.65-5.67). Relative risk of a second primary cancer was greatest for people who had childhood rhabdomyosarcoma (SIR, 19.9; 95% CI, 14.4-27.6). Relative risk was particularly high for children who had undergone both chemotherapy and radiotherapy (SIR, 9.80; 95% CI, 8.35-11.5). Relative risk peaked during the 5 years following the first diagnosis (2 to less than 5 years: SIR, 10.3; 95% CI, 8.20-13.0), but was still significant at 20-33 years (SIR, 2.58; 95% CI, 2.02-3.30). The most frequent second primary cancers were thyroid carcinomas (65 of 388, 17%) and acute myeloid leukaemias (57, 15%). CONCLUSIONS: Survivors of childhood cancer remain at increased risk of a second primary cancer well into adulthood. As the late effects of cancer treatment probably contribute to this risk, treatments need to be refined and their toxicity reduced, without reducing their benefit for survival.

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Medical Journal of Australia

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212

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3

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© 2020 AMPCo Pty Ltd. This is the peer reviewed version of the following article: Second primary cancers in people who had cancer as children: an Australian Childhood Cancer Registry population-based study, Medical Journal of Australia, 2020, 212 (3), pp. 121-125, which has been published in final form at https://doi.org/10.5694/mja2.50425. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions. This article may not be enhanced, enriched or otherwise transformed into a derivative work, without express permission from Wiley or by statutory rights under applicable legislation. Copyright notices must not be removed, obscured or modified. The article must be linked to Wiley’s version of record on Wiley Online Library and any embedding, framing or otherwise making available the article or pages thereof by third parties from platforms, services and websites other than Wiley Online Library must be prohibited.

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Biomedical and clinical sciences

Oncology and carcinogenesis

Psychology

Cancer

Childhood diseases

Epidemiology

Registries

Cancer

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Youlden, DR; Baade, PD; Green, AC; Valery, PC; Moore, AS; Aitken, JF, Second primary cancers in people who had cancer as children: an Australian Childhood Cancer Registry population-based study., Medical Journal of Australia, 2020, 212 (3), pp. 121-125

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